Telehealth for Parkinson disease patients during the COVID-19 pandemic: the TeleParkinson study

Abstract

Background Telemedicine allows Parkinson disease (PD) patients to overcome physical barriers to access health care services and increases accessibility for people with mobility impairments. Objective To investigate the feasibility indicators of a telehealth intervention for PD patients, including patient recruitment, attendance, technical issues, satisfaction, and benefits on levels of physical activity and sleep. Methods We conducted a single-center, single-arm study of telehealth video consultations using WhatsApp (Meta Platforms, Inc., Menlo Park, CA, USA). Also, we collected the feasibility indicators as the primary endpoints. All the patients in the study were previously evaluated in person by the same team. Results Patient recruitment, attendance, and technical issues rates were 61.3%, 90.5%, and 13.3%, respectively, with good scores of patient acceptance and satisfaction with the study intervention. The telehealth intervention improved physical activity, including the number of walks for at least 10 continuous minutes (p = 0.009) and the number of moderate-intensity activities lasting at least 10 continuous minutes (p = 0.001). The Pittsburgh sleep quality index (PSQI) scores also improved for one of its components: perceived sleep duration (p < 0.001) and for total Pittsburgh score (p < 0,001). The average travel time saving was 289.6 minutes, and money-saving was R$106.67 (around USD 18; almost 10% of the current minimum wage in Brazil). Conclusions Direct-to-patient telehealth video consultations proved to be feasible and effective and had a positive impact on physical activity levels and sleep in PD patients.

Utilization of telehealth services in low- and middle-income countries amid the COVID-19 pandemic: a narrative summary

“…Studies in low- and middle-income countries found telehealth services reduced travel time, prevented unnecessary visits and travel expenses associated with it, detected complications early, provided an early response to emergencies, e-prescriptions, more personalised attention, and increased accessibility in rural areas [ 16 , 21 , 25 , 32 , 36–41 ]. For example, a study in Brazil reports average travel time saved as a result of telehealth was 289.6 minutes, which accounted for R$106.67 saved [ 41 ].…”

“…In the reviewed literature, though we found telehealth services to be effective in many low- and middle-income countries, few studies found it to have no significant difference when compared with the existing system. Studies in Bangladesh on behavioral intention, in Brazil on mitigating the psychological impact of COVID-19, cerebral palsy, and Parkinson’s disease, in China on dementia, hypertension, and type 2 diabetes management, on emergency mHealth use, on retinopathy of prematurity and psychological distress, in Montenegro on neurosurgical care, in Paraguay on postoperative follow-up, in Thailand on type 2 diabetes and Turkey on autoimmune hepatitis, phenylketonuria, breathing exercise, type 2 diabetes, and mental health found a significant improvement in the healthcare services when telehealth services were employed compared to no implementation during the COVID-19 pandemic [ 23 , 24 , 27 , 41 , 43 , 44 , 56–68 ]. However, studies in Egypt on anticoagulants and myocardial infarction,in Georgia on self-injury, in Tunisia on children and adolescent arthritis, in Argentina on epilepsy, and in Brazil on type 2 diabetes management found no significant differences in healthcare service utilisation and overall health outcomes with the implementation of telehealth services [ 33 , 36 , 47 , 50 , 51 , 69 ].…”