Title: Devices for remote continuous monitoring of people with Parkinson’s disease (DAP61)
Funder: Department of Health and Social Care

Abstract: Parkinson's disease is a condition that affects the brain, resulting in a progressive loss of coordination and movement problems. In the early stages of Parkinson's disease, the 3 main symptoms are shaking (tremor), slowness of movement (bradykinesia) and muscle stiffness (rigidity). Other physical symptoms that can occur during the early stages of the disease include balance problems, nerve pain and sleep disturbance. People with advanced Parkinson’s disease may have more complex symptoms including anxiety, depression and dementia. Advanced Parkinson’s disease has a severe impact on the quality of life of patients, their families and carers. About 10% of patients have advanced disease._x000D_ _x000D_ The drug levodopa is used to manage motor symptoms, but it may cause motor complications, including fluctuation in response and involuntary limb movement (dyskinesia). Response fluctuations are characterised by large variations in motor performance, with normal function during the ‘on’ period, and weakness and restricted mobility during the ‘off’ period. ‘Wearing off’ of the drug or ‘End-of-dose’ deterioration with progressively shorter duration of benefit can also occur over time. Treatment can also cause side-effects such as impulse control disorders (e.g. compulsive gambling, hypersexuality, binge eating and obsessive shopping), excessive sleepiness or sudden onset of sleep and psychotic symptoms such as hallucinations and delusions. _x000D_ _x000D_ Remote monitoring devices could potentially be used to continuously measure the motor symptoms of Parkinson’s disease. They are intended to be used alongside subjective judgement in consultations between the patient and clinician to improve the management of symptoms. Remote monitoring devices include the Personal KinetiGraph (PKG) Movement Recording System (Global Kinetics), Kinesia 360 and KinesiaU (Great Lakes Neurotechnologies), PDMonitor (PD Neurotechnology) and STAT-ON (Sense4Care)._x000D_ _x000D_ The purpose of this project is to investigate the evidence on the potential clinical and economic value of all these remote monitoring devices, alongside clinician judgement, for monitoring motor and non-motor symptoms in people with Parkinson’s disease. To achieve this, we will search for all relevant published studies on PKG, Kinesia 360, KinesiaU, PDMonitor and STAT-ON and analyse the reported data to determine whether these technologies provide clinical benefits. If data permits, an economic analysis will be conducted to investigate whether using these devices represent value for money in the NHS.

Lay abstract: The purpose of this assessment is to investigate the use of remote monitoring devices for people with Parkinson’s disease. The assessment will consider the use of devices that continuously monitor motor symptoms, tremors and sleep disturbance, alongside clinical judgement, and their potential impact on treatment management and disease symptoms. The assessment will consider existing evidence (and identify potential evidence gaps) on whether PKG, Kinesia 360, KinesiaU, PDMonitor and STAT-ON have the potential to be clinically useful and cost-effective additions to current monitoring strategies.

Research activity codes: 6.3 MEDICAL DEVICES
Health categories: NEUROLOGICAL