Is it truly patient-centered? Doctor-patient communication in remote programming for Parkinson's disease

Patients with Parkinson's disease require frequent programming after deep brain stimulation (DBS) surgery to maintain therapeutic efficacy. Although remote programming promises a more patient-centered and accessible healthcare model, the transition from in-person to virtual visits may introduce unique barriers that compromise this innovative care model. From a doctor-patient communication perspective, this study explores these specific communication barriers and their subsequent impact on programming outcomes and patient experience.

Non-participatory observation and in-depth interviews were used to understand the experiences of patients, caregivers, and doctors regarding communication during remote programming of DBS. Thematic analysis was applied to analyze the qualitative data.

A total of 49 participants were enrolled. Three themes were identified: Structural changes in doctor-patient communication; Expanded patient responsibility; and Weakened emotional support. Findings indicate that Parkinson's patients face new barriers to communication access, heavier burdens of self-expression, and poorer outcomes in emotional communication.

The shift in programming models has introduced numerous new challenges for patients and their caregivers, including mastering digital devices, ensuring that home environments are suitable for online consultations, accurately describing symptoms, and accepting the absence of emotional comfort.