Regional centers, telehealth close Parkinson’s disease care gap in underserved areas

Key takeaways:

• Regional Parkinson’s disease centers dramatically reduced travel time for patients.
• Telehealth options bridge technological gaps for patients with Parkinson’s disease.

ORLANDO, Fla. — A “hub-and-spoke” model for Parkinson’s disease care featuring multiple regional centers that offered telehealth was effective at closing access gaps for individuals in Arkansas, according to a poster.

“In Arkansas we have a unique situation: there are only five movement disorders-trained neurologists to take care of Parkinson’s disease in the entire state, and four of them work in Little Rock,” Tuhin Virmani, MD, PhD, associate professor in the department of neurology at the University of Arkansas for Medical Sciences (UAMS), told Healio at the American Neurological Association annual meeting.

Nearly 50% of the PD-affected population resides 30 miles or more from the base of operations in the Arkansas state capital and approximately 50% to 60% of those individuals live in medically underserved areas, Virmani added.

Since the university positioned regional PD clinics throughout Arkansas, the researchers sought to determine if this placement, along with subsequent telehealth utilization, closed access gaps for patients with PD.

Their study collected data from 28 individuals (mean disease duration, 9.4±5.5 years; mean age, 71.4±8.4 years; 100% white; 79% gait affected) who lived in medically underserved areas. All participants had complete medical histories taken, along with cognitive evaluations and both motor and non-motor evaluations 6 weeks apart via telehealth at home as well as within a regional center and at the main UAMS movement disorders clinic in Little Rock.

In addition, surveys regarding access to care, as well as access to and comfort with technology, were scored on a Likert scale, with 0 indicating the most discomfort and 10 the greatest comfort level.

The Participants’ Area Deprivation Index scores for the current study ranked in the 76th percentile nationwide, compared with previous UAMS in-person studies that averaged in the 56th ADI percentile. Overall, 82% of participants reported home internet access, 89% reported presence of an internet provider near their homes and roughly 32% lacked a smartphone.

According to the results, regional center visits reduced round-trip travel burden by at least 150 miles for approximately half of study participants. About 75% of enrollees stated reliance on others for transportation to the main center at UAMS, 43% of whom relied on someone other than a spouse for transport.

Participants reported that telehealth greatly eased access to care, with a portion of the 24 individuals given an exit survey reporting less discomfort using digital paraphernalia.

“Hopefully, down the road we’ll be able to leverage local visits through the hub-and-spoke model to allow people to access this kind of care that they were only able to access because this was a research study,” Virmani said.