Tablet-based patient educational interventions in care and management of complex movement disorders

Abstract

Background

Patient education is an essential part of management of complex, disabling neurological disorders. Mobile web-based educational materials provide a novel and potentially valuable means to communicate clinical information that can aid in both medical management and rehabilitation.

Aims

We, therefore, evaluated an educational tablet-based intervention in three patient cohorts regarding the following topics: Parkinson’s disease (PD) medications, dystonia and botulinum toxin treatment.

Methods

A total of 50 subjects with PD, 32 with dystonia and 61 receiving botulinum toxin treatment for movement disorders or sialorrhoea were enrolled. Participants in each cohort completed a specific educational module at the time of their regularly scheduled clinic visit, comprising slides, in addition to pre- and post-module quizzes and a satisfaction survey. Additionally, participants in the dystonia and botulinum toxin modules were given a follow-up test at their 3- or 6-month clinical treatment visit.

Results

There were 143 participants with 50 completing the PD module, 32 completing the dystonia module and 61 completing the botulinum toxin module. All three groups demonstrated significant improvement in knowledge of module content between their pre- and post-module test scores (PD: p=.0001, dystonia: p<.0001 and botulinum toxin: p=.008), and those who took the dystonia module maintained significant improvement at either a 3- or 6-month follow up compared to pre-module (p <.0001).

Conclusions

Tablet-based teaching modules are an effective means of communicating key concepts to patients. This study supports their use for improving patient understanding that can support lifelong approaches to managing disabling, neurological conditions.

Implication for Rehabilitation

• Tablet-based modules are relatively easy to use for enhancing education during clinic visits and can possibly help reduce and maintain disability with chronic conditions like Parkinson’s disease and dystonia.

• Improvements in post-test scores suggested that patient participants were able to retain information from the tablets about their complex and challenging conditions and treatments.

• Adding patients who are fluent in another language would have made this study more generalizable and future studies exploring educational interventions are warranted to help better tailor interventions to patients with chronic neurologic illnesses to help understand the complex aspects of their medical and rehabilitation therapy.

• The effect of cognitive changes in neurological conditions and understanding of educational information needs to be further tested.

• This positive result is especially meaningful during the COVID-19 pandemic when in-person access to both medical and rehabilitative care has been curtailed.

Keywords:

• Patient education
• Parkinson’s disease
• dystonia
• disability
• botulin toxin
• e-learning

Acknowledgements

The authors would like to thank all of our subjects for participating in our research project and for their thoughtful feedback. The authors also like to thank our chief librarian Judy Stribling for initial study concept and research.

Disclosure statement

Natalie Hellmers has nothing to disclose.

Samantha Barkan has nothing to disclose.

Gabrielle Auerbach has nothing to disclose.

Aneliya Hanineva has nothing to disclose.

Paul Popa has nothing to disclose.

Additional information

Funding

There was no financial funding specific to this project but two of the authors have industry relationships. Dr. Harini Sarva has the following financial disclosures: had received 5% support from the Michael J Fox Foundation, received clinical trial support from Biogen, Insightec, Intect and Lundbeck Pharmaceuticals, and has received some internal funding from Cornell. She has also served on advisor boards for Merz and Amneal pharmaceuticals. She has served as an independent video rater for Neurocrine Neurosciences. Dr. Claire Henchcliffe: has received consultancy fees from US WorldMeds, Adamas Pharmaceuticals, Prevail Therapeutics and Mitsubishi Tanabe Pharma America.