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Konitsiotis S, Alexoudi A, Zikos P, Sidiropoulos C, Tagaris G, Xiromerisiou G, Tsamis K, Kostikis N, Kanellos F, Ntanis A, Kontaxis S, Rigas G. Paradigm shift in Parkinson's disease: using continuous telemonitoring to improve symptoms control. Results from a 2-years journey. Front Neurol 2024; 15:1415970. [PMID: 38903169 PMCID: PMC11187095 DOI: 10.3389/fneur.2024.1415970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/16/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction Conventional care in Parkinson's disease (PD) faces limitations due to the significant time and location commitments needed for regular assessments, lacking quantitative measurements. Telemonitoring offers clinicians an opportunity to evaluate patient symptomatology throughout the day during activities of daily living. Methods The progression of PD symptoms over a two-year period was investigated in patients undergoing traditional evaluation, supplemented by insights from ambulatory measurements. Physicians integrated a telemonitoring device, the PDMonitor®, into daily practice, using it for informed medication adjustments. Results Statistical analyses examining intra-subject changes for 17 subjects revealed a significant relative decrease of -43.9% in the device-reported percentage of time spent in "OFF" state (from 36.2 to 20.3%). Following the 24-month period, the majority of the subjects improved or exhibited stable symptom manifestation. In addition to positively impacting motor symptom control, telemonitoring was found to enhance patient satisfaction about their condition, medication effectiveness, and communication with physicians. Discussion Considering that motor function is significantly worsened over time in patients with PD, these findings suggest a positive impact of objective telemonitoring on symptoms control. Patient satisfaction regarding disease management through telemonitoring can potentially improve adherence to treatment plans. In conclusion, remote continuous monitoring paves the way for a paradigm shift in PD, focusing on actively managing and potentially improve symptoms control.
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Affiliation(s)
- Spyridon Konitsiotis
- University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Athanasia Alexoudi
- Department of Neurology, Neurological Institute of Athens, Athens, Greece
| | - Panagiotis Zikos
- Department of Neurology, 251 Hellenic Air Force Hospital, Athens, Greece
| | | | - George Tagaris
- Department of Neurology, General Hospital of Athens, “Georgios Gennimatas”, Athens, Greece
| | | | - Konstantinos Tsamis
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Foivos Kanellos
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
- PD Neurotechnology Ltd., Ioannina, Greece
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Buscemi V, Boaz A, Dawes H, Jaki T, Jones F, Marsden J, Paul L, Playle R, Randell E, Robling M, Rochester L, Busse M, Ramdharry G. Exploring the issues that influence how people with rare neurological conditions engage in physical activity. Disabil Rehabil 2024; 46:2789-2798. [PMID: 37401644 DOI: 10.1080/09638288.2023.2230128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE People with rare neurological conditions (RNCs) struggle to achieve regular physical activity (PA). This study explored experiences of people with RNC engaging in PA, their carers, and health care professionals (HCPs) working with them. MATERIALS & METHODS We developed three surveys: for individuals living with RNCs, their carers, and HCPs working with them. Themes from interviews with RNC charity representatives were used to co-design questions, together with people living with RNCs, their representatives, and an expert panel. Surveys were disseminated via charity mailing lists, social media accounts, and professional networks (HCPs). RESULTS We received 436 responses (225 people with RNC, 94 carers, 117 HCPs). Most respondents with RNC achieved some level of regular PA but needed motivation to maintain it. Many felt they lacked knowledge on starting and staying active, with scarce resources and support. Most HCP respondents worked in specialist services, and overwhelmingly agreed that people with RNC should be physically active, while acknowledging lack of evidence and resources. CONCLUSIONS We identified key barriers at environmental/organisational, interpersonal, and intrapersonal levels, highlighting a critical lack of support for people with RNC across UK health services. These factors can be targeted to increase engagement in PA.Implications for rehabilitationPeople living with rare neurological conditions experience barriers to engaging in physical activity, with some common to more prevalent neurological diseases, e.g. access and facilities, but some notable differences due to the rarity of the conditionFor people living with rare neurological conditions, and their carers, there is a lack of knowledge on safe and appropriate engagement in physical activityIncreasing the knowledge of health and exercise professionals may improve how they support people with rare neurological disease to engage with physical activity.Evidence based resources and recommendations for people living with rare neurological conditions, and professionals working with them, may facilitate engagement in physical activity.
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Affiliation(s)
- Valentina Buscemi
- Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, UCLH NHS Trust, London, UK
- Department of Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - Annette Boaz
- Faculty of Health, Social Care and Education, St. George's University of London, London, UK
- Faculty of Health, Social Care and Education, Kingston University, London, UK
| | - Helen Dawes
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Thomas Jaki
- Department of Mathematics and Statistics, University of Lancaster, Lancaster, UK
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Fiona Jones
- Faculty of Health, Social Care and Education, St. George's University of London, London, UK
- Faculty of Health, Social Care and Education, Kingston University, London, UK
| | | | - Lorna Paul
- Department of Physiotherapy and Paramedicine, Glasgow Caledonian University, Glasgow, UK
| | - Rebecca Playle
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Lynn Rochester
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Monica Busse
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Gita Ramdharry
- Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, UCLH NHS Trust, London, UK
- Department of Neuromuscular Diseases, UCL Institute of Neurology, London, UK
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Angelopoulou E, Kontaxopoulou D, Fragkiadaki S, Stanitsa E, Pavlou D, Papatriantafyllou J, Koros C, Dimovski V, Šemrov D, Papageorgiou SG. Perceptions of Patients, Caregivers, and Healthcare Professionals toward Telemedicine Use for Cognitive and Movement Disorders in the Aegean Islands, Greece: A Pilot Study of the SI4CARE European Project. Geriatrics (Basel) 2023; 9:3. [PMID: 38247978 PMCID: PMC10801565 DOI: 10.3390/geriatrics9010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Patients with neurodegenerative diseases who live in remote areas often have limited access to specialized healthcare, and telemedicine represents a useful solution. The aim of this study was to investigate the perceptions toward the use of a specialized-tertiary telemedicine service of patients with cognitive and movement disorders, caregivers, and local healthcare professionals (HPs) in the Aegean Islands. METHODS Data were derived from the "Specialized Outpatient Clinic of Memory, Dementia and Parkinson's disease through the National Telemedicine Network", March 2021-March 2023. The survey included 10 questions (5-point Likert scale). RESULTS We received 64 questionnaires (25 patients, 18 caregivers, 21 HPs). Most participants positively perceived all aspects of telemedicine, including comfort (mean ± standard deviation: patients 4.5 ± 0.9, caregivers: 4.8 ± 0.5, HPs: 4.6 ± 0.7), access to specialized care (4.7 ± 0.6, 4.7 ± 0.5, 4.9 ± 0.4), number of transportations (4.6 ± 0.8, 4.6 ± 0.9, 4.8 ± 0.5), adequacy of follow-up (4.6 ± 0.7, 4.4 ± 0.8, 4.2 ± 0.7), future telemedicine selection (4.8 ± 0.4, 4.8 ± 0.4, 4.6 ± 0.6), perceived reliable medical assessment (4.7 ± 0.5, 4.6 ± 0.6, 4.3 ± 0.6), information delivery (4.7 ± 0.6, 4.6 ± 0.5, 4.4 ± 0.9), health status improvement (4.6 ± 0.7, 4.6 ± 0.6, 4.0 ± 0.7), cost (4.6 ± 1, 4.6 ± 1, 5.0 ± 0.2), and general satisfaction (4.8 ± 0.4, 4.7 ± 0.5, 4.5 ± 0.6). The commonest recommendations were more frequent visits, medical specialties, and dissemination of information. CONCLUSIONS The positive perception of participants highlights the value of telemedicine for specialized healthcare for neurodegenerative disorders, especially in remote areas.
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Affiliation(s)
- Efthalia Angelopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Stella Fragkiadaki
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Evangelia Stanitsa
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Dimosthenis Pavlou
- School of Topography and Geoinformatics, University of West Attica, Ag. Spyridonos Str., 12243 Aigalew, Greece;
| | - John Papatriantafyllou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Christos Koros
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Vlado Dimovski
- School of Economics and Business, University of Ljubljana, Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Darja Šemrov
- Faculty of Civic and Geodetic Engineering, University of Ljubljana, Jamova Cesta 2, 1000 Ljubljana, Slovenia
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
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Walker R, Fothergill-Misbah N, Kariuki S, Ojo O, Cilia R, Dekker MCJ, Agabi O, Akpalu A, Amod F, Breckons M, Cham M, Del Din S, Dotchin C, Guggsa S, Kwasa J, Mushi D, Nwaokorie FO, Park T, Rochester L, Rogathi J, Sarfo FS, Shalash A, Ternent L, Urasa S, Okubadejo N. Transforming Parkinson's Care in Africa (TraPCAf): protocol for a multimethodology National Institute for Health and Care Research Global Health Research Group project. BMC Neurol 2023; 23:373. [PMID: 37858118 PMCID: PMC10585779 DOI: 10.1186/s12883-023-03414-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disorder and, according to the Global Burden of Disease estimates in 2015, was the fastest growing neurological disorder globally with respect to associated prevalence, disability, and deaths. Information regarding the awareness, diagnosis, phenotypic characteristics, epidemiology, prevalence, risk factors, treatment, economic impact and lived experiences of people with PD from the African perspective is relatively sparse in contrast to the developed world, and much remains to be learned from, and about, the continent. METHODS Transforming Parkinson's Care in Africa (TraPCAf) is a multi-faceted, mixed-methods, multi-national research grant. The study design includes multiple sub-studies, combining observational (qualitative and quantitative) approaches for the epidemiological, clinical, risk factor and lived experience components, as appropriate, and interventional methods (clinical trial component). The aim of TraPCAf is to describe and gain a better understanding of the current situation of PD in Africa. The countries included in this National Institute for Health and Care Research (NIHR) Global Health Research Group (Egypt, Ethiopia, Ghana, Kenya, Nigeria, South Africa and Tanzania) represent diverse African geographies and genetic profiles, with differing resources, healthcare systems, health and social protection schemes, and policies. The research team is composed of experts in the field with vast experience in PD, jointly led by a UK-based and Africa-based investigator. DISCUSSION Despite the increasing prevalence of PD globally, robust data on the disease from Africa are lacking. Existing data point towards the poor awareness of PD and other neurological disorders on the continent and subsequent challenges with stigma, and limited access to affordable services and medication. This multi-site study will be the first of its kind in Africa. The data collected across the proposed sub-studies will provide novel and conclusive insights into the situation of PD. The selected country sites will allow for useful comparisons and make results relevant to other low- and middle-income countries. This grant is timely, as global recognition of PD and the public health challenge it poses builds. The work will contribute to broader initiatives, including the World Health Organization's Intersectoral global action plan on epilepsy and other neurological disorders. TRIAL REGISTRATION https://doi.org/10.1186/ISRCTN77014546 .
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Affiliation(s)
- R Walker
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - N Fothergill-Misbah
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - S Kariuki
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - O Ojo
- College of Medicine, University of Lagos, Lagos, Nigeria
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - R Cilia
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M C J Dekker
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - O Agabi
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - A Akpalu
- University of Ghana Medical School, Korle Bu Teaching Hospital, Accra, Ghana
| | - F Amod
- University of KwaZulu-Natal, Durban, South Africa
| | - M Breckons
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - M Cham
- Richard Novati Catholic Hospital, Sogakope, Ghana
| | - S Del Din
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - C Dotchin
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - S Guggsa
- Addis Ababa University, Addis Ababa, Ethiopia
| | - J Kwasa
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | - D Mushi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - F O Nwaokorie
- Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - T Park
- Parkinson's Africa, Kingston upon Thames, UK
| | - L Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Rogathi
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - F S Sarfo
- Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | - A Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - L Ternent
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - S Urasa
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - N Okubadejo
- College of Medicine, University of Lagos, Lagos, Nigeria
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