9FEASIBILITY OF A WEARABLE TECHNOLOGY BASED VIRTUAL CLINIC FOR PEOPLE WITH PARKINSON’S

Abstract

Introduction: The Parkinson's service in Cardiff and Vale cares for over 1,500 people with Parkinson's (PwP) and related disorders. NICE recommends offering 6 to 12 monthly follow up clinic appointments (NICE guideline NG71, July 2017). We propose an innovative approach using telemedicine and wearable technology to meet increasing demand on services and provide quality care delivered to patients at home. Methods: The service has over 18 months' experience using the Parkinson's Kinetigraph (PKG); a wearable device that measures bradykinesia, dyskinesia and tremor giving a report to facilitate enhanced clinical decision making (Santiago et al, J Parkinsons Dis, Nov 18). Using the PKG report as a surrogate for the point-in-time clinical examination, we set up a virtual clinic. Interventions: Patients are sent virtual clinic appointments and are called on the phone by a doctor. The results of their recent PKG are discussed, along with any symptoms or concerns. Clinic letters are sent to GPs advising on medication changes. We plan to alternate between virtual and face-to-face clinics for each patient 6 monthly. Data has been collected on the consultation outcomes and anonymous feedback questionnaires sent by post. Results: 28 patients have virtual clinic appointments over 5 clinics, mean age 71 (range 54-81). 82% of appointments are successful, where a clinical decision could be made. This could be a medication change (n = 13) or no action required (n = 10). The reasons that clinical decisions could not be made included needing a BP reading (n = 2) and complex stage of disease (n = 2). 93% of those who responded to the questionnaire (n = 15) agreed they were satisfied with phone clinic, particularly highlighting convenience and transport issues. Conclusions: Virtual clinics are feasible, effective and acceptable to PwP. Success could be improved by referral criteria. The concept appears scalable. Larger clinics and a cost analysis are planned to confirm this.