mHealth platform for Parkinson’s Disease management

ABOUT PD_manager (Grant no. 643706)

Duration: 3 years from January 2015 – December 2017

Coordinator(s): PD_manager was led by Prof. Angelo Antonini, Professor of Neurology at the University of Padua and director of the Parkinson Department at the Institute of Neurology (IRCCS, San Camillo Hospital, Venice). The Scientific Coordinator was Prof  Dimitrios I. Fotiadis from University of Ioannina.

Project partners: The consortium comprised 11 partners from 6 countries.

Source of funding: Coordination and Support Action funded under the European Commission’s Horizon 2020 Framework Programme, Theme H2020-PHC-2014-2015

Background

In Europe more than one million people live with Parkinson’s today and this number is forecast to double by 2030. The economic impact of the disease is enormous – the annual European cost is estimated at €13.9 billion. Parkinson’s is a complicated, individual disorder that most people live with for many years/decades. For this reason, a multidisciplinary disease management, involving several professions working together (neurologists, physiotherapists, speech and language therapists, occupational therapists, dieticians), is important to ensure that the patient retains his/her independence and continues to enjoy the best quality of life possible. As an EU-funded project, PD_manager related to the PHC-26-2014 topic self-management of health and disease with focus on mHealth application for disease management. The project aimed to build and evaluate an innovative, mhealth, patient centric ecosystem for Parkinson’s disease (PD) management.

Aim & Project Deliverable(s)

The management of Parkinson Disease can be greatly improved by providing to the clinicians objective data about symptoms; data unobtrusively collected by the patient himself or his caregiver in more severe cases.

Therefore, the PD_manager project was set up with various objectives, such as modelling the behaviours of intended users of PD_manager (patients, caregivers, neurologists and other health-care providers), educate patients, caregivers and healthcare providers and to propose a set of unobtrusive, simple-in-use, co-operative, mobile devices that will be used for symptoms monitoring and collection of adherence data.

With PD_manager it will be possible to evaluate symptoms (Tremor, bradykinesia, gait and postural balance, dyskinesia, speech disorders, smleep disturbance) and to assess the main cognitive and mental symptoms/comorbidities (cognitive disorders, depression and anxiety, compulsive behavior). PD_manager will also enable the clinical experts and the patient and his/her caregivers to evaluate adherence to:

  • medication that will be remotely monitored with a smart pillbox
  • diet that will be part of a mobile app
  • physiotherapy; collected data for which will help physical therapists monitor the activities of their patients and guide them through their exercises at home
  • physical activity plan that will be assessed mainly with a wristband

The analysis of experts’ diagnostic behaviour and the decomposition of tasks undertaken by the various actors during the disease management will enable the validation of technology against routine clinical judgment measures . Primary motor symptoms such as tremor, bradykinesia and postural imbalance and non-motor symptoms, such as sleep, speech and cognitive disorders, will be evaluated with data captured by light, unobtrusive, co-operative, mobile devices: sensor insoles, a wristband and the patient’s or caregiver’s (the role of which is of paramount importance) smartphone. Data mining studies will lead to the implementation of a Decision Support Platform with suggestions for modifications in the medication which is the key for prolongation of independence and improved Quality of Life. Compliance with medical recommendations will also be studied; the patient will be motivated to adhere to his medication and diet, will be empowered to exercise and make physiotherapies and will be educated about occupational and speech therapy in order to self-manage his condition.

The project analysed proposed, and validated strategies to help physicians and healthcare professionals to search and evaluate the most diagnostic information (i.e., the information that is most relevant to help PD patients to cope with their symptoms, relief from them and make the best of their resources). Better understanding experts’ use of the available information will in turn inform and guide the development of models and the setup and the revision of the mobile devices.  This led to the ability to provide personalized suggestions for an optimal PD management plan. An open architecture based on Fi-ware Generic enablers that will support the use of any commercial set of sensors within the Internet of Things concept was be proposed.

The successful implementation of all abovementioned objectives were be evaluated in a total of 230 patients. In addition to the evaluation of the usability and usefulness of the developed platform and mobile apps a detailed study for the potential of PD_manager as a new care model in terms of health outcomes, quality of life, care efficiency gains and economic benefits were also conducted.

ROLE of EuroFIR AISBL in PD_manager

PD Manager had a variety of objectives that aim to build and evaluate an innovative, mhealth, patient-centric, ecosystem for management of Parkinson’s disease. EuroFIR AISBL was a subcontractor for the Jozsef Stefan Institute (JSI) for the optimisation of nutrition for individuals with Parkinson’s disease. EuroFIR was be involved in the nutritional aspects of field labs and provide food composition data for brand foods, recipes and dietary country-specific recommendations including Italy and Greece. A mobile app with evidence-based dietary support for those with Parkinson’s disease was developed for use in Slovenia, Italy and Greece. EuroFIR AISBL also supported further development of the Open Platform for Clinical Nutrition to which the mobile app will be linked.

Find out more

For more information visit the PD_manager website

Twitter: @pd_manager_proj