Telemonitoring via Questionnaires Reduces Outpatient Healthcare Consumption in Parkinson's Disease.

Wijers, Anke; Hochstenbach, Laura; Tissingh, Gerrit

Background Parkinson's disease (PD) is best managed by neurologists, traditionally including frequent doctor-patient contact. Because of a rise in PD prevalence and associated healthcare costs, this personnel-intensive care may not be future proof. Telemedicine tools for home monitoring have shown to reduce healthcare consumption in several chronic diseases and also seem promising for PD. Objective To explore whether telemonitoring can reduce outpatient healthcare consumption in PD. Methods We conducted a cohort study with 116 outpatients with PD who used the telemedicine tool "myParkinsoncoach." The tool involved periodic monitoring, feedback, knowledge modules, and text message functionality. Retrospective data about PD-related healthcare consumption in the year before and after introduction of the tool were retrieved from the hospital information system. Additional data about tool-related activities performed by nursing staff were logged prospectively for 3 months. Results There was a 29% reduction in the number of outpatient visits (P < 0.001) in the year after introduction of the tool compared with the year before. A 39% reduction was seen in overall PD-related healthcare costs (P = 0.001). Similar results were found for patients ≥70 years old. Nursing staff spent on average 15.5 minutes per patient a month on monitoring the tool and follow-up activities. Conclusions Study results demonstrate a significant reduction in PD-related healthcare consumption using telemonitoring. Notably, these results were also found in elderly patients. Further research is needed to confirm these findings, preferably taking a broader perspective on healthcare consumption and within a larger, multicenter and prospective setup.