Thea Dominey

Abstract

Parkinson’s disease (PD) is a common progressive neurological disorder characterised by a complex range of motor and non-motor symptoms (NMS). Current PD service provision does not meet the needs of patients, and puts pressure on services with limited capacity. Digital Health Technologies (DHTs), including body-worn sensors and portable devices, may provide advantages, by enabling continual and objective monitoring of symptoms, and facilitating patient self-management. I carried out a series of studies and evaluations of DHTs for use in PD, to evaluate their ability to identify and monitor symptoms in both a clinical and research context. These included: 1. The evaluation of a computerised paced finger tapping task (PFT) that was found to correlate with a measure of verbal fluency, suggesting there may be potential to implement the PFT as part of a wider finger tapping battery to be used as a screening tool for PD executive dysfunction. 2. The iterative, user-centred design and formative evaluation of NMS Assist, a smartphone-based app to enable regular assessment of NMS as well as provide education for patients. The app was found to be highly usable, and key areas of amendment were identified. 3. A clinical service evaluation of the PKGTM, a PD remote monitoring device. The findings revealed the PKGTM is useful for identifying patients with unmet treatment need, even in newly diagnosed people with Parkinson’s (PwP) who experience more frequent clinic review. 4. A systematic review of neuroprotective trial design in PD. The results demonstrated a wide range of primary outcome measures is used across trials, and there is little evidence of patient stratification. The findings highlighted the potential for DHTs to improve various aspects of clinical trial design. I discuss the potential value of DHTs, as well as challenges associated with their use, identified as a result of this research.

Document Type

Thesis

Publication Date

2019-01-01

DOI

10.24382/770

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