A reminder app for supporting adherence to treatment goals in PD
Research type
Research Study
Full title
A single case experimental design study of a reminder app for supporting adherence to personalised treatment goals in Parkinson’s Disease
IRAS ID
301026
Contact name
Jonathan Evans
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 1 months, 25 days
Research summary
Research Summary
Parkinson’s Disease is a progressive condition which affects the nervous system causing tremors, slowed movement and often causes problems with memory and initiaion. Treatment management can be complex and challenging for patients and families. Poor memory in Parkinson’s disease has been shown to reduce a person’s ability to manage activities of daily living, including tasks associated with treatment such a taking medications. However, patients with Parkinson’s have been shown to benefit from external reminders.
The aim of this research project is to investigate whether the use of a reminder app that has been designed for use by people with cognitive difficulties improves completion of activities related to therapy goals in people with Parkinson’s Disease, aiding self-management of their condition.
Patients seen in movement disorder clinics in NHS Greater Glasgow and Clyde with a diagnosis of Parkinson’s disease, and a partner or carer who can monitor progress, will be invited to participate. Measures of memory, emotional wellbeing and quality of life will be completed to characterise each participant. Participants will have a randomly allocated initial baseline period of either 10, 16 or 22 days in which their rate of completion of intended activities will be monitored. Then, during the intervention period of 3 weeks (21 days) the ApplTree app (Jamieson et al., 2020) will be introduced to remind participants of treatment goals. Participants will create specific and personalised treatment goals at the beginning of the monitoring period. Goals will be everyday activities relevant to the management and treatment of Parkinson’s disease. The number of goals is not limited and will depend on how frequent targeted behaviours are. However, at least one target behaviour a day in total will be recommended. E.g. Completing daily exercises. Partners will monitor their goal attainment, via a daily/weekly monitoring form in both phases of the study.
Summary of Results
Who has conducted the research?
The research was undertaken by Georgina Rayment (Trainee Clinical Psychologist, Principal researcher) as part of a Doctorate in Clinical Psychology, with Professor Jonathan Evans (Chief Investigator) and Dr Salma Iqbal from the University of Glasgow and NHS Greater Glasgow and Clyde. NHS Greater Glasgow and Clyde (NHS GG&C) is the sponsor for this study based in the United Kingdom.
Background
Parkinson’s disease is a progressive condition which affects the nervous system causing tremors and slowed movement. Other symptoms that some people experience include problems with balance, sleep, memory and anxiety. Treatment aims to improve symptoms and quality of life. Difficulties with memory for people with Parkinson’s disease have been shown to reduce a person’s ability to manage activities of daily living, including things like taking medications. However, people with Parkinson’s disease have been shown to benefit greatly from external reminders to support remembering.
Aims and Questions
The aim of this research project was to investigate whether the use of a reminder app improves the ability to remember to carry out activities that are relevant to personal treatment goals in people with Parkinson’s disease.
Methods
Patients seen by the movement disorder clinic with a diagnosis of Parkinson’s and a partner who was able to monitor progress were invited to take part in the study. Written consent to take part was acquired from each participant. Seven participants were recruited from a movement disorder service, six completing the study. Measures of memory, emotional wellbeing and quality of life were completed to build a profile of each participant. Participants had a ‘baseline’ phase at the start where they carried on as usual, but their partner recorded whether or not they completed daily goal-related tasks. The baseline phase varied in length for each person. Participants created specific and personalised treatment goals at the beginning of the baseline phase. Goals were relevant to the management and treatment of Parkinson’s disease. Then, an intervention phase was completed with the ApplTree app introduced to remind participants of treatment goals. This design is known as a single case experimental design. Partners monitored their goal adherence, via a weekly monitoring form in both phases.Results
All participants decided to use the app for goals around increasing activity and exercise and nearly all used the app to assist with taking regular medications. Visual analysis of graphs revealed that nearly all participants, except one, displayed an improvement between baseline and interventions phases with the introduction of the reminder app. However, further analysis suggested that the introduction of the reminder app led to a statistically significant improvement in goal-related tasks for two participants.Conclusions
This research provided evidence that a smartphone reminder app can help some people with Parkinson’s disease to carry out goal-related tasks. This suggests that a reminder app can help people to take a more active role in self-management of Parkinson’s Disease. Some participants completed a high level of goal-related tasks in the baseline phase. It may be that the goal setting session, prompts from partners and interaction with the researcher motivated participants to complete daily goal-related tasks before introduction of the reminder app. This may explain why improvements found in the intervention phase were only significant for two participants. Measures of memory for all participants included in the study showed they did not have major difficulties; future research could look at the effect of the reminder app in people with Parkinson’s disease who have more severe memory difficulties. Finally, the majority of participants continued to use a reminder app for treatment related goals past the end of the study. Future research should investigate the acceptability of reminder apps for people with Parkinson’s disease and consider long-term follow-up to see whether use of these apps is maintained over time.REC name
West of Scotland REC 3
REC reference
21/WS/0154
Date of REC Opinion
10 Jan 2022
REC opinion
Further Information Favourable Opinion