NHS study finds mobile app improves management, quality of doctor visits for people with Parkinson's Disease

By Heather Mack
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People with Parkinson’s disease who used an app to track and manage symptom improved their medication adherence and had better conversations with clinicians about their condition, according to the results of a recent National Health Services study published in the journal Nature Parkinson’s.  

Representing the largest randomized controlled trial of a digital technology for Parkinson’s Disease, the study enrolled 215 people with Parkinson’s in seven leading neurology departments across England and Scotland. Roughly half were given the uMotif mobile app to function as a regular diary over a 16 week period. Participants recorded symptoms and medication dosages and played cognitive games on the app, then brought that data to follow-up consultations with their doctors. Those using the app showed a 10 percent improvement in adherence as well as improvement in their care experience with their doctor.

“These findings suggest that the PTA (Parkinson’s Tracking App) can be useful in improving outcomes and processes of care in people with PD (Parkinson’s Disease), similar to results seen in other chronic conditions such as diabetes and asthma,” the study authors write. “Given that typical follow-up of patients with PD by clinical care teams in the UK occurs approximately every 6 months (by consultants or nurse specialists), this finding suggests PTA is useful in improving care for a significant period of time between clinic consultations.”

While medication adherence is a huge part – and the primary outcome focus of the study – the improved quality of doctor visits and a feeling of greater agency over their condition was an important measure for study participants, the researchers found, aligning with their goals toward patient-centered care.

“Self-management support and shared decision-making have been identified as two promising ways to support and empower PD patients … PD patients desire more emotional support from healthcare professionals and want more active involvement in clinical decision-making,” the researchers write. “Other studies have found that PD patients who perceived higher involvement in their care were more satisfied with the consultation and intended to be more compliant with treatment.”

One study participant, identified only as Mick by the uMotif team in a video about his experience with app, said the app helped him keep things in perspective about his condition. By having a daily log of dosage, symptoms and a boost from the cognitive games, he was able to stop generalizing how he felt and could actually notice incremental changes or even improvements in his condition.

“I was tending to focus on the more downside all the time; you tend to think you are more down than you really are,” he said in the video. “Rather than saying, oh, I felt like this for that whole week – because you don’t remember, I don’t know if anybody does –  I can actually take the phone with me and say, this is what I’m on, this is the dosage and so forth, its right there. It’s done away with having to remember, it’s there in basically, black and white, I have a history to tell. It’s there in my diary. So when I go to see the neurologist, I can tell them exactly how it’s been, not how I think I remember it has been. And it teaches you as well—don’t beat yourself up because you can’t do what you used to do, look at more what you are doing.”

The researchers also pointed out that technology innovations like uMotif aren’t just for younger populations more associated with being tech-savvy and open-minded to novel therapies. As smartphone market penetration continues to increase with time, especially with older populations, they anticipate even more patients will use the app.

“It should be noted that a mean age of 60 in the PTA group was not a barrier for interaction with the PTA, allaying fears that technology-based interventions are not appropriate for an older age group,” the researchers write.

The study, which was funded by the NHS’s Small Business Research Initiative, also suggests an additional benefit: potential cost savings in the millions. Globally, Parkinson’s affects some 6.3 million people. More than 127,000 of those people are in the UK, and if the uMotif platform (which is also used in 15 other clinical conditions, such as arthritis) was deployed in neurology departments across the UK, it could save the NHS an estimated 20 million pounds ($24.6 million) each year.

“Today’s NHS is all about embracing proven new technologies like uMotif’s to make a difference to patients’ experience of care, and to help improve services across the country,” Juliet Bauer, NHS England’s Director of Digital Experience, said in a statement. “We’re delighted to see the growing evidence base of how such technologies can make a real difference.”Air Max 95 Flyknit