24/7 Live Stream Telemedicine Home Treatment Service for Parkinson's Disease Patients

Treatment of advanced-stage idiopathic Parkinson's disease (PD) is a demanding challenge, and in Germany, medication regimen adjustments are often made during inpatient stays. Admissions often follow an acute worsening of symptoms and functioning. In order to reduce long and expensive inpatient stays, and to provide more frequent consultations, a 24/7 live stream telemedicine home treatment service was established.

A pilot study was conducted in which laptops were distributed to 50 patients for 1 year to see whether such a service was feasible (in terms of patient participation and compliance) and whether this intervention affected the patient's condition, measured in UPDRS, Mini-Mental Status Examination (MMSE), 39-item Parkinson's Disease Questionnaire (PDQ39), and H & Y Scale.

Seventy-two percent (36) of the patients were compliant and did not experience technical issues. Patients lived, on average, 198 ± 183 km away from the specialist clinic. In total, 264 video conversations took place with 6.9 ± 7.2 (0-29) calls per patient. We found a significant improvement in PDQ39 scores, but not in UPDRS, MMSE, or H & Y scores, at 1 year.

Our data shows that 24/7 live stream telemedicine is feasible and can help to improve quality of life. However, a detailed preliminary review of the patient's willingness to use such a service should be made to obtain the best results. Improvement of the technical setup and network coverage would facilitate an improved service and increase efficiency.