PLoS ONE (Jan 2021)

Adopting a multidisciplinary telemedicine intervention for fall prevention in Parkinson's disease. Protocol for a longitudinal, randomized clinical trial.

  • Esther Cubo,
  • Alvaro Garcia-Bustillo,
  • Alvar Arnaiz-Gonzalez,
  • Jose Miguel Ramirez-Sanz,
  • Jose Luis Garrido-Labrador,
  • Florita Valiñas,
  • Marta Allende,
  • Jeronimo Javier Gonzalez-Bernal,
  • Josefa Gonzalez-Santos,
  • José Francisco Diez-Pastor,
  • Maha Jahouh,
  • Jana Arribas,
  • Jose Trejo

DOI
https://doi.org/10.1371/journal.pone.0260889
Journal volume & issue
Vol. 16, no. 12
p. e0260889

Abstract

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BackgroundApproximately 40-70% of people with Parkinson's disease (PD) fall each year, causing decreased activity levels and quality of life. Current fall-prevention strategies include the use of pharmacological and non-pharmacological therapies. To increase the accessibility of this vulnerable population, we developed a multidisciplinary telemedicine program using an Information and Communication Technology (ICT) platform. We hypothesized that the risk for falling in PD would decrease among participants receiving a multidisciplinary telemedicine intervention program added to standard office-based neurological care.ObjectiveTo determine the feasibility and cost-effectiveness of a multidisciplinary telemedicine intervention to decrease the incidence of falls in patients with PD.MethodsOngoing, longitudinal, randomized, single-blinded, case-control, clinical trial. We will include 76 non-demented patients with idiopathic PD with a high risk of falling and limited access to multidisciplinary care. The intervention group (n = 38) will receive multidisciplinary remote care in addition to standard medical care, and the control group (n = 38) standard medical care only. Nutrition, sarcopenia and frailty status, motor, non-motor symptoms, health-related quality of life, caregiver burden, falls, balance and gait disturbances, direct and non-medical costs will be assessed using validated rating scales.ResultsThis study will provide a cost-effectiveness assessment of multidisciplinary telemedicine intervention for fall reduction in PD, in addition to standard neurological medical care.ConclusionIn this challenging initiative, we will determine whether a multidisciplinary telemedicine intervention program can reduce falls, as an alternative intervention option for PD patients with restricted access to multidisciplinary care.Trial registrationClinicalTrials.gov Identifier: NCT04694443.