Randomized Controlled Clinical Trial of 'Virtual House Calls' for Parkinson Disease

JAMA Neurolology, Vol. 70, No. 3, pp. 293-294, 2013 (DOI: 10.1001/jamaneurol.2013.1610)

6 Pages Posted: 4 May 2013

See all articles by E. Ray Dorsey

E. Ray Dorsey

Johns Hopkins University

Vinayak Venkataraman

Johns Hopkins University

Matthew Grana

University of Rochester Medical Center

Michael Bull

University of Rochester

Benjamin George

University of Rochester

Cynthia Boyd

Johns Hopkins University

Christopher Beck

Biostats Computational Biology

Balaraman Rajan

California State University, East Bay; University of Rochester - Simon School of Business

Abraham Seidmann

University of Rochester - Simon Business School

Kevin Biglan

Neurology Movement Disorders

Date Written: March 11, 2013

Abstract

Importance: The burden of neurological disorders in increasing, but access to care is limited. Providing specialty care to patients via telemedicine could help alleviate this growing problem.

Objective: To evaluate the feasibility, effectiveness, and economic benefits of using web-based videoconferencing (telemedicine) to provide specialty care to patients with Parkinson disease in their homes.

Design: A 7-month, 2-center, randomized controlled clinical trial.

Setting: Patients' homes and outpatient clinics at two academic medical centers.

Participants: Twenty patients with Parkinson disease with Internet access at home.

Intervention: Care from a specialist delivered remotely at home or in person in the clinic.

Main Outcome Measures: The Primary outcome variable was feasibility, as measured by the percentage of telemedicine visits completed as scheduled. Secondary outcome measures included clinical benefit, as measured by the 39-item Parkinson Disease Questionnaire, and economic value, as measured by time and travel.

Results: Twenty participants enrolled in the study and were randomly assigned to telemedicine (n=9) or in-person care (n=11). Of the 27 scheduled telemedicine visits, 25 (93%) were completed, and of the 33 schedules in-person visits, 30 (91%) were completed (P=.99). In this small study, the change in quality of life did not differ for those randomly assigned to telemedicine compared with those randomly assigned to in-person care (4.0-point improvement vs 6.4-point improvement; P=.61). Compared with in-person visits, each telemedicine visit saved participants, on average, 100 miles of travel and 3 hours of time.

Conclusion and Relevance: Using web-based video-conferencing to provide specialty care at home is feasible, provides value to patients, and may offer similar clinical benefit to that of in-person care. Larger studies are needed to determine whether the clinical benefits are indeed comparable to those of in-person care and whether the results observed are generalizable.

Suggested Citation

Dorsey, E. Ray and Venkataraman, Vinayak and Grana, Matthew and Bull, Michael and George, Benjamin and Boyd, Cynthia and Beck, Christopher and Rajan, Balaraman and Seidmann, Abraham Avi and Biglan, Kevin, Randomized Controlled Clinical Trial of 'Virtual House Calls' for Parkinson Disease (March 11, 2013). JAMA Neurolology, Vol. 70, No. 3, pp. 293-294, 2013 (DOI: 10.1001/jamaneurol.2013.1610), Available at SSRN: https://ssrn.com/abstract=2247016

E. Ray Dorsey

Johns Hopkins University ( email )

Baltimore, MD 20036-1984
United States

Vinayak Venkataraman

Johns Hopkins University ( email )

Baltimore, MD 20036-1984
United States

Matthew Grana

University of Rochester Medical Center ( email )

Rochester, NY 14627
United States

Michael Bull

University of Rochester ( email )

300 Crittenden Blvd.
Rochester, NY 14627
United States

Benjamin George

University of Rochester ( email )

300 Crittenden Blvd.
Rochester, NY 14627
United States

Cynthia Boyd

Johns Hopkins University ( email )

Baltimore, MD 20036-1984
United States

Christopher Beck

Biostats Computational Biology ( email )

300 Crittenden Blvd.
Rochester, NY 14627
United States

Balaraman Rajan

California State University, East Bay ( email )

25800 Carlos Bee Boulevard
Hayward, CA California 94542
United States

University of Rochester - Simon School of Business ( email )

Rochester, NY 14627
United States

Abraham Avi Seidmann (Contact Author)

University of Rochester - Simon Business School ( email )

Carol Simon Hall 3-333C
Rochester, NY 14627
United States
585-275-5694 (Phone)
585-275-9331 (Fax)

HOME PAGE: http://www.ssb.rochester.edu/fac/Seidmannav/

Kevin Biglan

Neurology Movement Disorders ( email )

300 Crittenden Blvd.
Rochester, NY 14627
United States

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