Home-Based Titration with Duodenal Infusion of Levodopa-Carbidopa Intestinal Gel in People with Parkinson’s Disease: An Observational Feasibility Study

Parkinson’s Disease, 2024 · DOI: https://doi.org/10.1155/2024/5522824 · Published: April 8, 2024

Simple Explanation

This study explores whether people with Parkinson's can safely adjust their medication (levodopa) dosage at home instead of in a hospital. The study used telemedicine (video calls) to help monitor patients and provide support during the dosage adjustment process. The results showed that adjusting medication at home is feasible, safe, and satisfactory for patients and caregivers, and may reduce healthcare costs.

Study Duration

October 2017 to February 2022

Participants

12 PwPs (5 females and 7 males)

Evidence Level

Observational feasibility study

Key Findings

1
Telehealth-assisted home-based titration programs are feasible due to the length of the titration period, number of contacts, and time spent in PwPs’ private homes.
2
The program is rated satisfactory and safe by PwPs and caregivers and may be a substitute for in-hospital treatment.
3
The average score on the satisfaction evaluation questionnaires was lower in the caregiver group (mean 31.8) than the PwP outcome (mean 36.2).

Research Summary

This study assessed the feasibility and safety of home-based titration of levodopa duodenal infusions with the use of self-reported evaluation questionnaires, registration of total time used, and number of contacts/visits. A telemedicine solution was used to remotely monitor the patients, adjust treatment, and provide support and guidance to patients and caregivers. Telehealth-assisted home-based titration programs are feasible, are rated satisfactory and safe by PwPs and caregivers, and may be a substitute for in-hospital treatment.

Practical Implications

Home-Based Treatment

Home-based titration programs can be considered as a substitute for in-hospital treatment for PwPs receiving LCIG therapy.

Caregiver Support

Caregivers play a vital role in the success of home-based titration, requiring adequate support and information to manage the treatment effectively.

Telemedicine Integration

Telemedicine can be effectively used to monitor patients remotely, adjust treatment, and provide support to both patients and caregivers.

Study Limitations

1
Small sample size limits generalization of results.
2
Potential misunderstanding of questions in the PREM questionnaires.
3
Study primarily evaluated feasibility and applicability rather than a comprehensive clinical outcome assessment.

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