Fehlmann B, Thomann A, Davies E, Twiss J, Romano C, Whalley D, Mayorga M, Levy C, Lipsmeier F, Popp W, Kustermann T, Svoboda H, Nikolcheva T, Trundell D, Lindemann M, Taylor K. Patient perspectives on symptoms and functional impacts to inform a digital assessment of Parkinson's disease. Poster presented at the 2023 International Congress of Parkingson's Disease and Movement Disorders; August 27, 2023. Copenhagen, Denmark.

OBJECTIVE: The aim of this study is to map patients’ reports of functional limitations and impacts of Parkinson’s disease (PD) to motor signs captured with a digital health technology (DHT) tool – the Roche PD Mobile Application v2, comprising ten active motor tests.

BACKGROUND: DHTs enable the remote, scalable and frequent assessment of motor signs in people with PD (PwPD). One critical consideration in developing DHT outcome measures is that they are associated with the symptoms and impacts on daily life that matter most to patients.

METHOD: Motor symptoms and functional impacts of PD were identified from concept elicitation (CE) interviews in 44 PwPD (n= 22 H&Y 1, 2; n=22 H&Y 3). Cognitive debriefing (CD) interviews conducted 2 weeks later provided participants the opportunity to complete the DHT tests, describe the symptoms they experienced during the completion of each DHT test, and rate the importance of the symptoms to daily functioning on a 0 (not at all) to 10 (extremely) scale. Analysis involved thematic analysis methods for CE data and descriptive summaries for the CD data. DHT test symptom coverage was quantified by the relative frequency of participants reporting a given symptom.

RESULTS: The most frequently reported symptoms during CE were slow movements, stiffness and rigidity, and difficulty balancing/standing/walking (each 77.3%). The most frequently reported tremor types were kinetic (70.5%) and postural tremor (54.5%). The most frequently reported functional limitations included walking (88.6%), performing daily chores (63.6%) and standing from a seated position (59.1%). All reported symptoms across the entire cohort were covered by at least one, and often multiple DHT tests, with the expected mapping to the tests and high rated importance to daily functioning. For example, slow movement was predominantly captured with the Hand-Turning Test (median importance rating=7), whereas difficulty balancing when standing/walking was predominantly captured by the U-turn Test (median importance rating=9).

CONCLUSION: Patients interacting with the Roche PD Mobile Application v2 experienced similar difficulties and symptoms as during their daily lives, supporting the importance and relevance of this DHT for patients.

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