AUTHOR=Debelle Héloïse , Packer Emma , Beales Esther , Bailey Harry G. B. , Mc Ardle Ríona , Brown Philip , Hunter Heather , Ciravegna Fabio , Ireson Neil , Evers Jordi , Niessen Martijn , Shi Jian Qing , Yarnall Alison J. , Rochester Lynn , Alcock Lisa , Del Din Silvia 

TITLE=Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1111260

DOI=10.3389/fneur.2023.1111260

ISSN=1664-2295

ABSTRACT=Introduction: Parkinson’s disease (PD) is a neurodegenerative disorder which requires complex medication regimens to mitigate motor symptoms. The use of digital health technology systems (DHTS) to collect mobility and medication data provides an opportunity to objectively quantify the effect of medication on motor performance during day-to-day activities. This insight could inform clinical decision-making, personalise care, and aid self-management. This study investigates the feasibility and usability of a multi-component DHTS to remotely assess self-reported medication adherence and monitor mobility in people with Parkinson’s (PwP).

Methods: Thirty participants with PD [Hoehn & Yahr stage I (n=1) and II (n=29)] were recruited for this cross-sectional study. Participants were required to wear, and where appropriate, interact with a DHTS (smartwatch, inertial measurement unit, and smartphone) for seven consecutive days to assess medication adherence and monitor digital mobility outcomes and contextual factors. Participants reported their daily motor complications (motor fluctuations and dyskinesias) in a diary. Following the monitoring period, participants completed a questionnaire to assess the usability of the DHTS. Feasibility was assessed through the percentage of data collected, and usability through analysis of qualitative questionnaire feedback.

Results: Adherence to each device exceeded 70% and ranged from 73% to 97%. Overall, the DHTS was well tolerated with 17/30 participants giving a score > 75% (average score for these participants = 89%) for its usability [from 0 (worst) to 100 (best)]. Usability of the DHTS was significantly associated with age (ρ = -0.560, BCa 95% CI [-0.791, -0.207]). This study identified means to improve usability of the DHTS by addressing technical and design issues of the smartwatch. Feasibility, usability and acceptability were identified as key themes from PwP qualitative feedback on the DHTS.

Conclusion: This study highlighted the feasibility and usability of our integrated DHTS to remotely assess medication adherence and monitor mobility in PwP. Further work is necessary to determine whether this DHTS can be implemented for clinical decision-making to optimise management of PwP.