Developing home-based Parkinson’s care University Hospitals Plymouth NHS Trust

People with Parkinson’s (PwP) are more likely to be admitted to hospital and have a prolonged length of stay and increased mortality during admission. Most admissions are related to falls, chest infections and urinary infections.

Guidelines suggest that PwP should have a specialist review at least every six months. However, the caseload is often too high and clinic visits burdensome, especially in geographically large rural areas, such as in Devon and Cornwall.

This project, led by University Hospitals Plymouth NHS Trust, involved the development of an innovative care pathway with PwP, ‘home-based care’ (HBC), based on supported self-management, triggered contacts and digitally enabled remote monitoring. The aim was to empower patients to self-manage their Parkinson’s, with access to triggered reviews when needed.

The project introduced technology to enable the delivery of home-based assessment and care for PwP. The Parkinson’s Kinetigraph, developed by Global Kinetics Corporation, is a wrist-worn device which measures movement parameters. Patients are also given a non-motor symptom questionnaire.

The pathway was implemented in October 2019 and by January 2021, 111 patients had been enrolled onto it.

After six months on the HBC pathway, fewer PwP had severe non-motor symptom burden (33% vs 51%), depression (3% vs 9%) and anxiety (10% vs 19%). Patients felt more involved in their care (59% vs 41%), listened to (63% vs 47%) and treated as an individual (71% vs 57%).

The project has demonstrated the acceptability, feasibility and effectiveness of a novel digitally enabled PwP care pathway, with benefits to both patients and staff.

Contact information

For more information about this project, please contact Dr Camille Carroll, Associate Professor, University of Plymouth and Honorary Consultant Neurologist, University Hospitals Plymouth NHS Trust.