National randomized controlled trial of virtual house calls for Parkinson disease

Connect.Parkinson Investigators

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

CONCLUSIONS: Providing remote neurologic care directly into the homes of people with PD was feasible and was neither more nor less efficacious than usual in-person care. Virtual house calls generated great interest and provided substantial convenience.

CLINICALTRIALSGOV IDENTIFIER: NCT02038959.

CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with PD, virtual house calls from a neurologist are feasible and do not significantly change quality of life compared to in-person visits. The study is rated Class III because it was not possible to mask patients to visit type.

OBJECTIVE: To determine whether providing remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable.

METHODS: In a 1-year randomized controlled trial, we compared usual care to usual care supplemented by 4 virtual visits via video conferencing from a remote specialist into patients' homes. Primary outcome measures were feasibility, as measured by the proportion who completed at least one virtual visit and the proportion of virtual visits completed on time; and efficacy, as measured by the change in the Parkinson's Disease Questionnaire-39, a quality of life scale. Secondary outcomes included quality of care, caregiver burden, and time and travel savings.

RESULTS: A total of 927 individuals indicated interest, 210 were enrolled, and 195 were randomized. Participants had recently seen a specialist (73%) and were largely college-educated (73%) and white (96%). Ninety-five (98% of the intervention group) completed at least one virtual visit, and 91% of 388 virtual visits were completed. Quality of life did not improve in those receiving virtual house calls (0.3 points worse on a 100-point scale; 95% confidence interval [CI] -2.0 to 2.7 points; p = 0.78) nor did quality of care or caregiver burden. Each virtual house call saved patients a median of 88 minutes (95% CI 70-120; p < 0.0001) and 38 miles per visit (95% CI 36-56; p < 0.0001).

Original languageEnglish (US)
Pages (from-to)1152-1161
Number of pages10
JournalNeurology
Volume89
Issue number11
DOIs
StatePublished - Sep 12 2017
Externally publishedYes

Fingerprint

House Calls
Parkinson Disease
Randomized Controlled Trials
Quality of Health Care
Quality of Life
Confidence Intervals
Nervous System
Caregivers
Home Care Services
Masks
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

National randomized controlled trial of virtual house calls for Parkinson disease. / Connect.Parkinson Investigators.

In: Neurology, Vol. 89, No. 11, 12.09.2017, p. 1152-1161.

Research output: Contribution to journalArticle

Connect.Parkinson Investigators. / National randomized controlled trial of virtual house calls for Parkinson disease. In: Neurology. 2017 ; Vol. 89, No. 11. pp. 1152-1161.
@article{83bcda7ad6b04f0d85d6cda062a1a495,
title = "National randomized controlled trial of virtual house calls for Parkinson disease",
abstract = "CONCLUSIONS: Providing remote neurologic care directly into the homes of people with PD was feasible and was neither more nor less efficacious than usual in-person care. Virtual house calls generated great interest and provided substantial convenience.CLINICALTRIALSGOV IDENTIFIER: NCT02038959.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with PD, virtual house calls from a neurologist are feasible and do not significantly change quality of life compared to in-person visits. The study is rated Class III because it was not possible to mask patients to visit type.OBJECTIVE: To determine whether providing remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable.METHODS: In a 1-year randomized controlled trial, we compared usual care to usual care supplemented by 4 virtual visits via video conferencing from a remote specialist into patients' homes. Primary outcome measures were feasibility, as measured by the proportion who completed at least one virtual visit and the proportion of virtual visits completed on time; and efficacy, as measured by the change in the Parkinson's Disease Questionnaire-39, a quality of life scale. Secondary outcomes included quality of care, caregiver burden, and time and travel savings.RESULTS: A total of 927 individuals indicated interest, 210 were enrolled, and 195 were randomized. Participants had recently seen a specialist (73{\%}) and were largely college-educated (73{\%}) and white (96{\%}). Ninety-five (98{\%} of the intervention group) completed at least one virtual visit, and 91{\%} of 388 virtual visits were completed. Quality of life did not improve in those receiving virtual house calls (0.3 points worse on a 100-point scale; 95{\%} confidence interval [CI] -2.0 to 2.7 points; p = 0.78) nor did quality of care or caregiver burden. Each virtual house call saved patients a median of 88 minutes (95{\%} CI 70-120; p < 0.0001) and 38 miles per visit (95{\%} CI 36-56; p < 0.0001).",
author = "{Connect.Parkinson Investigators} and Beck, {Christopher A.} and Beran, {Denise B.} and Biglan, {Kevin M.} and Boyd, {Cynthia M.} and Dorsey, {E. Ray} and Schmidt, {Peter N.} and Richard Simone and Willis, {Allison W.} and Galifianakis, {Nicholas B.} and Maya Katz and Tanner, {Caroline M.} and Kristen Dodenhoff and Jason Aldred and Julie Carter and Andrew Fraser and Joohi Jimenez-Shahed and Christine Hunter and Meredith Spindler and Suzanne Reichwein and Zoltan Mari and Becky Dunlop and Morgan, {John C.} and Dedi McLane and Patrick Hickey and Lisa Gauger and Richard, {Irene Hegeman} and Mejia, {Nicte I.} and Grace Bwala and Martha Nance and Shih, {Ludy C.} and Carlos Singer and Silvia Vargas-Parra and Cindy Zadikoff and Natalia Okon and Andrew Feigin and Jean Ayan and Christina Vaughan and Rajesh Pahwa and Rohit Dhall and Anhar Hassan and Steven DeMello and Riggare, {Sara S.} and Paul Wicks and Achey, {Meredith A.} and Elson, {Molly J.} and Steven Goldenthal and Keenan, {H. Tait} and Ryan Korn and Heidi Schwarz and Saloni Sharma",
year = "2017",
month = "9",
day = "12",
doi = "10.1212/WNL.0000000000004357",
language = "English (US)",
volume = "89",
pages = "1152--1161",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - National randomized controlled trial of virtual house calls for Parkinson disease

AU - Connect.Parkinson Investigators

AU - Beck, Christopher A.

AU - Beran, Denise B.

AU - Biglan, Kevin M.

AU - Boyd, Cynthia M.

AU - Dorsey, E. Ray

AU - Schmidt, Peter N.

AU - Simone, Richard

AU - Willis, Allison W.

AU - Galifianakis, Nicholas B.

AU - Katz, Maya

AU - Tanner, Caroline M.

AU - Dodenhoff, Kristen

AU - Aldred, Jason

AU - Carter, Julie

AU - Fraser, Andrew

AU - Jimenez-Shahed, Joohi

AU - Hunter, Christine

AU - Spindler, Meredith

AU - Reichwein, Suzanne

AU - Mari, Zoltan

AU - Dunlop, Becky

AU - Morgan, John C.

AU - McLane, Dedi

AU - Hickey, Patrick

AU - Gauger, Lisa

AU - Richard, Irene Hegeman

AU - Mejia, Nicte I.

AU - Bwala, Grace

AU - Nance, Martha

AU - Shih, Ludy C.

AU - Singer, Carlos

AU - Vargas-Parra, Silvia

AU - Zadikoff, Cindy

AU - Okon, Natalia

AU - Feigin, Andrew

AU - Ayan, Jean

AU - Vaughan, Christina

AU - Pahwa, Rajesh

AU - Dhall, Rohit

AU - Hassan, Anhar

AU - DeMello, Steven

AU - Riggare, Sara S.

AU - Wicks, Paul

AU - Achey, Meredith A.

AU - Elson, Molly J.

AU - Goldenthal, Steven

AU - Keenan, H. Tait

AU - Korn, Ryan

AU - Schwarz, Heidi

AU - Sharma, Saloni

PY - 2017/9/12

Y1 - 2017/9/12

N2 - CONCLUSIONS: Providing remote neurologic care directly into the homes of people with PD was feasible and was neither more nor less efficacious than usual in-person care. Virtual house calls generated great interest and provided substantial convenience.CLINICALTRIALSGOV IDENTIFIER: NCT02038959.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with PD, virtual house calls from a neurologist are feasible and do not significantly change quality of life compared to in-person visits. The study is rated Class III because it was not possible to mask patients to visit type.OBJECTIVE: To determine whether providing remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable.METHODS: In a 1-year randomized controlled trial, we compared usual care to usual care supplemented by 4 virtual visits via video conferencing from a remote specialist into patients' homes. Primary outcome measures were feasibility, as measured by the proportion who completed at least one virtual visit and the proportion of virtual visits completed on time; and efficacy, as measured by the change in the Parkinson's Disease Questionnaire-39, a quality of life scale. Secondary outcomes included quality of care, caregiver burden, and time and travel savings.RESULTS: A total of 927 individuals indicated interest, 210 were enrolled, and 195 were randomized. Participants had recently seen a specialist (73%) and were largely college-educated (73%) and white (96%). Ninety-five (98% of the intervention group) completed at least one virtual visit, and 91% of 388 virtual visits were completed. Quality of life did not improve in those receiving virtual house calls (0.3 points worse on a 100-point scale; 95% confidence interval [CI] -2.0 to 2.7 points; p = 0.78) nor did quality of care or caregiver burden. Each virtual house call saved patients a median of 88 minutes (95% CI 70-120; p < 0.0001) and 38 miles per visit (95% CI 36-56; p < 0.0001).

AB - CONCLUSIONS: Providing remote neurologic care directly into the homes of people with PD was feasible and was neither more nor less efficacious than usual in-person care. Virtual house calls generated great interest and provided substantial convenience.CLINICALTRIALSGOV IDENTIFIER: NCT02038959.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with PD, virtual house calls from a neurologist are feasible and do not significantly change quality of life compared to in-person visits. The study is rated Class III because it was not possible to mask patients to visit type.OBJECTIVE: To determine whether providing remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable.METHODS: In a 1-year randomized controlled trial, we compared usual care to usual care supplemented by 4 virtual visits via video conferencing from a remote specialist into patients' homes. Primary outcome measures were feasibility, as measured by the proportion who completed at least one virtual visit and the proportion of virtual visits completed on time; and efficacy, as measured by the change in the Parkinson's Disease Questionnaire-39, a quality of life scale. Secondary outcomes included quality of care, caregiver burden, and time and travel savings.RESULTS: A total of 927 individuals indicated interest, 210 were enrolled, and 195 were randomized. Participants had recently seen a specialist (73%) and were largely college-educated (73%) and white (96%). Ninety-five (98% of the intervention group) completed at least one virtual visit, and 91% of 388 virtual visits were completed. Quality of life did not improve in those receiving virtual house calls (0.3 points worse on a 100-point scale; 95% confidence interval [CI] -2.0 to 2.7 points; p = 0.78) nor did quality of care or caregiver burden. Each virtual house call saved patients a median of 88 minutes (95% CI 70-120; p < 0.0001) and 38 miles per visit (95% CI 36-56; p < 0.0001).

UR - http://www.scopus.com/inward/record.url?scp=85030621426&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85030621426&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000004357

DO - 10.1212/WNL.0000000000004357

M3 - Article

C2 - 28814455

AN - SCOPUS:85030621426

VL - 89

SP - 1152

EP - 1161

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 11

ER -