The Feasibility and Practical Utility of Virtual Visits for Patients with Parkinson's Disease in Different World Regions

Abstract

Background: Overcoming existing access barriers is crucial for better-specialized health care ofpatients with Parkinson’s disease (PD).ObjectiveObjective: The aim of the study was to compare the access and visit quality/acceptability between in-office andvirtual telemedicine visits.MethodsMethods: This was an international, randomized, case-control, prospective, observational study. Patients wererandomly assigned either to the control group (in-person/in-office visits at baseline, 3, 6, 9, and 12 months) or tothe study group (in-office visits at baseline, 6, and 12 months, and telemedicine visits at 3 and 9 months).Telemedicine visits were conducted using videoconferencing apps that were readily accessible to the patient/caregivers. Outcomes were feasibility, usability, and the noninferiority of telemedicine compared to in-officevisits in PD patients regarding clinical progression and initiation of pharmacological/nonpharmacologicaltreatments over 1-year follow-up.ResultsResults: We included 209 PD patients from 6 countries (Nigeria, Spain, Saudi Arabia, South Korea, Egypt, andUruguay), mean age 64.9 12.2 years, 59% males, median Hoehn & Yahr stage 2 (1–4). Overall, diseaseprogression (MDS-Unified PD rating scale), quality of life (PD-Quality of life 39-items) scores, and therapeuticchanges were similar in both groups. After 1 year, 124 patients 48.3%, (control group) and 52.1% (study group)completed the visits (P = 0.52), with a similar high rate of patient’s satisfaction with the visits (P = 0.57).ConclusionsConclusions: This study represents real-world telemedicine practice in different world regions using atelemedicine approach complementary to in-person visits. Based on these results, feasibility, clinicalmanagement, PD disease progression, and patient’s quality of life are similar when using telemedicine versusin-office visits. Future research should explore ways to integrate different healthcare technologies for long-termPD management.