Five technologies that could help improve symptoms and quality of life for people with Parkinson’s disease have been conditionally recommended by the National Institute for Health and Care Excellence (NICE).
The wearable devices have sensors that monitor the symptoms of people with the condition while they go about their day-to-day life.
NICE said this information may more accurately record a person’s symptoms than a clinical assessment during in-person appointments and help to inform medication decisions and follow-up treatment such as physiotherapy.
Parkinson's disease is an incurable condition that affects the brain, resulting in progressive loss of coordination and movement problems. It is caused by loss of the cells in the brain that are responsible for producing dopamine, which helps to control and coordinate body movements.
People with Parkinson’s disease experience a range of motor symptoms, which can fluctuate in severity. Motor symptoms may include dyskinesia (involuntary movement), bradykinesia (slowness) and tremor; non-motor symptoms include sleep disturbances.
Evidence collection
NICE’s independent diagnostics advisory committee has recommended the NHS collects real world evidence on five technologies.
The Personal KinetiGraph (PKG) movement recording system from Global Kinetics is a watch that measures patients’ movements and quantify disorder symptoms such as tremors and slowness. It includes event markers for medication reminders and patient acknowledgement.
STAT-ON from Sense4care is a waist-worn inertia recorder, configured by a doctor, which measures motor disorders and events such as involuntary movements and falls when worn by someone with Parkinson’s, but does not measure tremor. It can also register when medication has been taken, with up to 10 alarms per day to act as prompts.
Kinesia 360 from Great Lakes Neurotechnologies monitors physical motion and muscle activity to analyse how people are able to move and how their condition is progressing. Sensors worn on the wrist and ankle combined with a mobile phone app record data, including involuntary movement and tremor. The app also includes electronic diaries for capturing patient-reported outcomes and customisable medication diaries.
The same company has developed KinesiaU, which measures tremor, slowness and involuntary movement using a smartwatch and smartphone app. Patients can view reports in real time and share these with their healthcare professionals. It also includes customisable medication and exercise diaries.
PDMonitor from PD Neurotechnology is worn on the wrist, ankles or waist to measure activity/posture, slowness, gait disturbances, freezing of gait, wrist tremor, leg tremor, involuntary movement and on and off periods. The PDMonitor SmartBox is a docking station for charging the monitoring devices, collecting, storing and processing data and uploading them to the PD Neurotechnology storage service, and the device’s mobile app has a diary for medications, diet and symptoms.
Transformative effect
Mark Chapman, interim director of medical technology at NICE, said: “Providing wearable technology to people with Parkinson’s disease could have a transformative effect on their care and lead to changes in their treatment taking place more quickly.
“However, there is uncertainty in the evidence at present on these five promising technologies which is why the committee has conditionally recommended their use by the NHS while data is collected to eliminate these evidence gaps.
“We are committed to balancing the best care with value for money, delivering both for individuals and society as a whole, while at the same time driving innovation into the hands of health and care professionals to enable best practice.”
NICE has asked the NHS to provide further evidence on: the impact on resources associated with using the technologies for people with Parkinson’s disease and their carers; the impact on symptoms or health related quality of life and how long this lasts for; how frequently the devices are used and under what circumstances.
The NHS has already started data collection as hundreds of patients have already been issued with the PKG watch.
A consultation has now begun on the recommendations and people can have their say via the NICE website until 18 October 2022.
