WASHINGTON — An iPad app diary may help track Parkinson’s disease symptoms and have implications for clinical care, an ongoing study indicates.
Codrin Lungu, MD, of the National Institutes of Health, and colleagues, who presented the results in a poster session at the American Academy of Neurology 2015 Annual Meeting, sought to address the gap in clinical data collection that often occurs in patients with progressive illness such as Parkinson’s disease who may only see a clinician two to three times per year. The long spaces of time between visits with a neurologist may result in discrepancies in memory and difficulty evaluating responses to medications.
“It’s a big area of need in terms of gathering patient reported outcomes, which I believe is more relevant than things we can do in the office,” Lungu told Neurology Advisor. “It also allows us to obtain a large amount of data in a more reliable way, and in a way that’s more directly analyzable by the physician, which can translate into therapeutic decisions for the patient.”
During app development, the researchers observed visits between patients and neurologists to better understand what topics were most likely to be discussed, how often specific health events were included in neurological histories, how patients described changes in symptoms, and how they tracked changes in those symptoms.
In a pilot study, 18 patients tested the Movement Disorders Journal (MD Journal) app, which included an analog scale with graphical representation that documented slowness, tremor, gait/balance, dyskinesia, and mood. The app also allows for patients to record audio/video and text descriptions of their current condition.
“The app can be used in two ways: one as a log at the daily level to track activity over the long-term, which could be applied while running a new therapy trial,for example, and second as a 30-minute interval input meant for more targeted monitoring, ideal for guiding therapy response,” Lungu said.
The app also functions as a medication alarm and tracker. “The app allows tracking of doses of medication with reliable timing, it integrates an alarm system to prompt patents to take medications, and it gives a good picture of how each medication adjustment changes symptom control,” Lungu said.
All 18 patients in the pilot study were successfully able to utilize the device and provide accurate answers using the simple interface, which was tested by patients, caregivers, and physicians; however Lungu stressed that the future would likely hold many changes and adjustments to the app in order to create a valuable product for both patient and physician.
“App development will continue to be an iterative process; we will continue to get feedback and we will continue to refine it.”
The app, which can export the data representative of a patient’s disease state and progression for easy analyses, is currently being tested in a short-term usability study and afterwards will be evaluated longer, more extensive studies to address long-term viability of data collection.
“There is a lot of convergent interest [in this project] in the community so we’re looking forward to collaborating and expanding the application of this app across different patient populations,” Lungu said.