Initiation of Levodopa-Carbidopa Intestinal Gel Infusion Using Telemedicine (Video Communication System) Facilitates Efficient and Well-Accepted Home Titration in Patients with Advanced Parkinsons Disease

Autor: Jörgen Larsson, Peter Grenholm, Håkan Widner, Thomas Willows, Kristina Groth, Johan Permert, Susanna Kjellander, Ursula Schmiauke, Nil Dizdar, Dag Nyholm, Anna Urbom
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Research Report
Time Factors
Neurology
Parkinson's disease
020205 medical informatics
Neurologi
Video Recording
Advanced Parkinsons disease
levodopa-carbidopa intestinal gel
LCIG
duodenal levodopa-carbidopa infusion
Duodopa
telemedicine
video communication system
home titration
routine patient care
healthcare resource utilization
02 engineering and technology
Antiparkinson Agents
Levodopa
0302 clinical medicine
0202 electrical engineering
electronic engineering
information engineering
Carbidopa
Parkinson Disease
Middle Aged
Telemedicine
Intestines
Drug Combinations
Treatment Outcome
Female
medicine.drug
medicine.medical_specialty
Nursing
03 medical and health sciences
Cellular and Molecular Neuroscience
medicine
Humans
In patient
Adverse effect
Video communication system
Aged
Sweden
Advanced Parkinson’s disease
business.industry
Omvårdnad
medicine.disease
Advanced Parkinson's disease
Physical therapy
Neurology (clinical)
business
Gels
030217 neurology & neurosurgery
Zdroj: Journal of Parkinson's Disease
Popis: Background: Levodopa-carbidopa intestinal gel (LCIG; Duodopa r) is used for continuous infusion in advanced Parkinsons disease. To achieve optimal effect, the LCIG dose is individually titrated, traditionally conducted during hospitalization in Sweden. However, dose adjustment depends on surrounding conditions, physical activity, and emotional stress, which is why titration at home could be beneficial. Telemedicine (TM) using a video communication system offers alternative titration procedures, allowing LCIG initiation at home. Objective: Study objectives were to show the feasibility of TM for LCIG home titration, evaluate resource use, and assess patient, neurologist, and nurse satisfaction. Methods: Four clinics enrolled 15 patients to observe efficiency and feasibility of TM-based monitoring. Results: Patient median (range) age was 67 (52-73) years and time since diagnosis was 10 (7-23) years. Median time between LCIG initiation and end of TM-assisted titration was 2.8 (2.0-13.8) days. Median time required for home titration by neurologists, nurses, and patients was (hours: minutes) 1 : 14 (0 : 29-1 : 52), 5 : 49 (2 : 46-10 : 3), and 8 : 53 (4 : 11-14 : 11), respectively. Neurologists and nurses considered this to be less time than required for hospital titration. TM allowed patients 92% free time from start to end of titration. Technical problems associated with TM contacts were rare, mostly related to digital link, and quickly resolved. Patients, neurologists, and nurses were satisfied using TM. No serious adverse events were reported; there was one device complaint (tube occlusion). Conclusions: In this study, TM-assisted LCIG titration at home was resource-efficient, technically feasible, well-accepted and was deemed satisfactory by patients, neurologists, and nurses. Funding Agencies|AbbVie AB
Databáze: OpenAIRE
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