Pilot Randomized Controlled Trial of Telemedicine for Individuals With Parkinson Disease in a Rural Population (Tele-PD)
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Purpose
To eliminate barriers (such as travel and cost) to specialized Parkinson disease (PD) care, two movement disorder specialists at the University of Rochester will be providing telemedicine visits for patients with PD who reside in the Presbyterian Home for Central New York in New Hartford, NY, or for individuals who participate in the local support group that meets at the nursing home. Participants will attend 3 telemedicine visits at the Presbyterian Home over the course of 6 months.
We hypothesize that this telemedicine model will in time improve access to care and hence the quality of life and quality of care of individuals with PD.
| Condition |
|---|
|
Parkinson Disease |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Pilot Randomized Controlled Trial of Telemedicine for Individuals With Parkinson Disease in a Rural Population |
- The feasibility of telemedicine, based on participant ability to complete 75% or more of the trial visits. [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Parkinson's Disease Questionnaire-39 (PDQ-39) [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- EuroQol (EQ-5D) [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Geriatric Depression Scale Short Form (GDS-15) [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Modified Group Health Association of America's Consumer Satisfaction Survey (GHAA) [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Qualitative assessment, including a telemedicine focus group and 1:1 interviews with study participants [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Enrollment: | 14 |
| Study Start Date: | April 2008 |
| Study Completion Date: | November 2008 |
| Primary Completion Date: | November 2008 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
|
1
Telemedicine care
|
|
2
Standard of care
|
Detailed Description:
Study participants are recruited from the Presbyterian Home and from the Central New York Parkinson Support Group. Anyone interested will attend a screening and baseline visit at the Presbyterian Home, where they will receive baseline surveys and a motor assessment. Eligible participants will be randomized to receive either telemedicine or standard of care.
Each telemedicine visit (Month 1, Month 3, Month 6) will take place in a 1:1 fashion between the study participant and the physician investigator - one of two movement disorder specialists from the University of Rochester - via televideo linkage, and will last approximately 30-60 minutes. The study participant will be observed by the physician investigator and she/he will be accompanied by a Presbyterian Home staff member to ensure safety throughout the telemedicine visit. The visit will be structured much the same as a standard clinical visit and will include:
- Study participant's update on his or her clinical condition
- Review of current medications, which will be provided in advance of the visit
- Review and update of medical and social histories
- Vital signs, including weight (provided by the Presbyterian Home staff)
- Pertinent neurological exam, including a modified motor examination led by physician investigator
- Assessment of current clinical state
- Dictated recommendations including a letter to the attending physician for ongoing clinical care, including changes to the PD medications
Participants assigned to the control group will receive their care as routinely scheduled with their own primary care physician and/or neurologist.
Staff members from the University of Rochester will return to the Presbyterian Home within one month of the six month study to complete final assessments with all study participants. These will include:
- Reportable events form
- Health care events form
- Quality of life and healthcare evaluation surveys
- Continuation of care survey
- 1:1 interviews
- Telemedicine focus groups
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Study participants will be recruited from the Presbyterian Home Parkinson disease nursing home, assisted living, independent living, and adult day care populations, as well as the local PD support group that meets monthly at the Presbyterian Home.
Inclusion Criteria:
- Willing and able to provide informed consent
- Age 30 years old or older
- Clinical diagnosis of idiopathic Parkinson's disease as determined by having two of the four cardinal features of PD (rest tremor, bradykinesia, cogwheel rigidity, and gait instability) and no better alternative explanation for the etiology of the symptoms
- Able to converse in English
- Willing and able to complete study requirements
Exclusion Criteria:
- Any neurological, medical, or psychiatric condition that would preclude the patient having the ability to provide informed consent or to participate in the telemedicine visit.
Contacts and Locations| United States, New York | |
| Presbyterian Home for Central New York, Inc. | |
| New Hartford, New York, United States, 13413 | |
| Principal Investigator: | E. Ray Dorsey, MD, MBA | University of Rochester |
| Principal Investigator: | Kevin Biglan, MD, MPH | University of Rochester |
More Information
Publications:
| Responsible Party: | E. Ray Dorsey, MD, MBA, University of Rochester |
| ClinicalTrials.gov Identifier: | NCT00668551 History of Changes |
| Other Study ID Numbers: | RSRB00022923 |
| Study First Received: | April 25, 2008 |
| Last Updated: | April 10, 2009 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Rochester:
|
Parkinson disease Telemedicine |
Additional relevant MeSH terms:
|
Parkinson Disease Parkinsonian Disorders Basal Ganglia Diseases Brain Diseases |
Central Nervous System Diseases Nervous System Diseases Movement Disorders Neurodegenerative Diseases |
ClinicalTrials.gov processed this record on June 18, 2013