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June 2016; 6 (3) Research

High patient satisfaction with telehealth in Parkinson disease

A randomized controlled study

Jayne R. Wilkinson, Meredith Spindler, Stephanie M. Wood, Steven C. Marcus, Daniel Weintraub, James F. Morley, Margaret G. Stineman, John E. Duda
First published May 3, 2016, DOI: https://doi.org/10.1212/CPJ.0000000000000252
Jayne R. Wilkinson
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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Meredith Spindler
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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Stephanie M. Wood
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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Steven C. Marcus
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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Daniel Weintraub
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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James F. Morley
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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Margaret G. Stineman
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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John E. Duda
Parkinson's Disease Research, Education and Clinical Center (PADRECC) (JRW, MS, SMW, DW, JFM, JED), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Neurology (JRW, MS, DW, JFM, JED), Department of Psychiatry (DW), and Department of Physical Medicine Rehabilitation (MGS), Perelman School of Medicine of the University of Pennsylvania, Philadelphia; and School of Social Policy and Practice (SCM), University of Pennsylvania, Philadelphia.
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Citation
High patient satisfaction with telehealth in Parkinson disease
A randomized controlled study
Jayne R. Wilkinson, Meredith Spindler, Stephanie M. Wood, Steven C. Marcus, Daniel Weintraub, James F. Morley, Margaret G. Stineman, John E. Duda
Neurol Clin Pract Jun 2016, 6 (3) 241-251; DOI: 10.1212/CPJ.0000000000000252

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Abstract

Background: Parkinson disease (PD) is a complex neurodegenerative disorder that benefits from specialty care. Telehealth is an innovative resource that can enhance access to this care within a patient-centered framework. Research suggests that telehealth can lead to increased patient satisfaction, equal or better clinical outcomes, and cost savings, but these outcomes have not been well-studied in PD.

Methods: We conducted a dual active-arm 12-month randomized controlled trial to assess patient satisfaction, clinical outcomes, travel burden, and health care utilization in PD using video telehealth for follow-up care with specialty providers. Telehealth visits took place either at a facility nearer to the patient (satellite clinic arm) or in the patient's home (home arm). Each control group received usual in-person care. Patient satisfaction, assessed by quantitative questionnaires, was the primary outcome.

Results: Eighty-six men were enrolled (home arm: 18 active, 18 control; satellite clinic arm: 26 active, 24 control) with a mean age of 73 years (range 42–87). There were no differences in baseline characteristics between the active group and the controls in each arm (p > 0.05). A significant difference in overall patient satisfaction was not found; however, high levels of patient satisfaction were found in all groups. Greater satisfaction for the telehealth modality was found in assessments of convenience and accessibility/distance. Clinical outcomes were similar between groups, travel burden was reduced using telehealth, and health care utilization was largely similar in both groups.

Conclusions: As the need for PD subspecialty care increases, innovative patient-centered solutions to overcoming barriers to access, such as video telehealth, will be invaluable to patients and may provide high patient satisfaction.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

  • Editorial, page 203

  • Supplemental data at Neurology.org/cp

  • Received October 28, 2015.
  • Accepted March 8, 2016.
  • © 2016 American Academy of Neurology
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