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Real-World Evaluation of the Feasibility, Acceptability and Safety of a Remote, Self-Management Parkinson's Disease Care Pathway: A Healthcare Improvement Initiative

Lookup NU author(s): Professor Camille CarrollORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

© 2024 - The authors. Published by IOS Press.Background: There is significant unmet need for effective and efficiently delivered care for people with Parkinson's disease (PwP). We undertook a service improvement initiative to co-develop and implement a new care pathway, Home Based Care (HBC), based on supported self-management, remote monitoring and the ability to trigger a healthcare contact when needed. Objective: To evaluate feasibility, acceptability and safety of Home Based Care. Methods: We evaluated data from the first 100 patients on HBC for 6 months. Patient monitoring, performed at baseline and 6-monthly, comprised motor (MDS-UPDRS II and accelerometer), non-motor (NMSQ, PDSS-2, HADS) and quality of life (PDQ) measures. Care quality was audited against Parkinson's UK national audit standards. Process measures captured feasibility. Acceptability was assessed using a mixed-methods approach comprising questionnaires and semi-structured interviews. Results: Between October 2019 and January 2021, 108 PwP were enrolled onto HBC, with data from 100 being available at 6 months. Over 90% of all questionnaires were returned, 97% were complete or had < 3 missing items. Reporting and communications occurred within agreed timeframes. Compared with baseline, after 6m on HBC, PD symptoms were stable; more PwP felt listened to (90% vs. 79%) and able to seek help (79% vs. 68%). HBC met 93% of national audit criteria. Key themes from the interviews included autonomy and empowerment. Conclusions: We have demonstrated acceptability, feasibility and safety of our novel remotely delivered Parkinson's care pathway. Ensuring scalability will widen its reach and realize its benefits for underserved communities, enabling formal comparisons with standard care and cost-effectiveness evaluation.


Publication metadata

Author(s): Kehagia AA, Chowienczyk S, Helena Van Velthoven M, King E, North T, Shenton D, Abraham J, Langley J, Partridge R, Ankeny U, Gorst T, Edwards E, Whipps S, Batup M, Rideout J, Swabey M, Inches J, Bentley S, Gilbert G, Carroll C

Publication type: Article

Publication status: Published

Journal: Journal of Parkinson's Disease

Year: 2024

Volume: 14

Issue: 1

Pages: 197-208

Online publication date: 23/01/2024

Acceptance date: 02/04/2018

Date deposited: 11/02/2025

ISSN (print): 1877-7171

ISSN (electronic): 1877-718X

Publisher: IOS Press BV

URL: https://doi.org/10.3233/JPD-230205

DOI: 10.3233/JPD-230205

Data Access Statement: The data supporting the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions

PubMed id: 38250784


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Funding

Funder referenceFunder name
Health Foundation, UK (ref: 1119597)
Parkinson’s UK service improvement grant (ref: SIG2018).

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