Virtual visits for Parkinson disease: A multicenter noncontrolled cohort.

Autor:	Korn RE; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Wagle Shukla A; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Katz M; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Keenan HT; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Goldenthal S; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Auinger P; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Zhu W; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Dodge M; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Rizer K; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Achey MA; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Byrd E; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Barbano R; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Richard I; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Andrzejewski KL; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Schwarz HB; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Dorsey ER; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Biglan KM; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Kang G; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Kanchana S; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Rodriguez R; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Tanner CM; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL., Galifianakis NB; University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL.
Jazyk:	angličtina
Zdroj:	Neurology. Clinical practice [Neurol Clin Pract] 2017 Aug; Vol. 7 (4), pp. 283-295.
DOI:	10.1212/CPJ.0000000000000371
Abstrakt:	Background: Previous small-scale studies have demonstrated the feasibility of providing remote specialty care via virtual visits. We assessed the feasibility and benefits of a one-time consultation between a remote Parkinson Disease (PD) specialist and an individual with PD at home on a larger scale. Methods: We conducted a multicenter noncontrolled cohort of virtual visits administered over videoconferencing between remote PD specialists and individuals with PD in their home. Specialists performed a patient history and a PD-specific physical examination and provided recommendations to patients and their local physicians. The primary outcome measures were feasibility, as measured by the proportion of visits completed as scheduled, and the 6-month change in quality of life, as measured by the Parkinson's Disease Questionnaire 39. Additional outcomes included satisfaction with visits and interest in future virtual visits. Results: A total of 277 participants from 5 states enrolled, 258 participants completed virtual visits with 14 different physicians, and 91% of visits were completed as scheduled. No improvement in quality of life was observed at 6 months (0.4-point improvement; 95% confidence interval -1.5 to 0.6; p = 0.39). Overall satisfaction with virtual visits was high among physicians (94% satisfied or very satisfied) and patients (94% satisfied or very satisfied), and 74% of participants were interested in receiving future care via virtual visits. Conclusions: Providing specialty care remotely into the homes of individuals with PD is feasible, but a one-time visit did not improve quality of life. Satisfaction with the visits was high among physicians and patients, who were interested in receiving such care in the future. Classification of Evidence: This study provides Class IV evidence that for patients with PD, remote specialty care is feasible but does not improve quality of life. Clinicaltrialsgov Identifier: NCT02144220.
Databáze:	MEDLINE
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