Transformation of Parkinson's care through SMART-PD (Self-Management, Remote monitoring and Timely review for Parkinson's Disease): Care pathway mapping with clinical experts

Purpose of researchSMaRT-PD is a clinical decision support system (CDSS) for the home-based management and care of Parkinson's disease. It utilises remote monitoring and artificial intelligence to generate patient and clinician-facing outputs with self-management guidance, care recommendations and triggered follow-up appointments when needed. This study aimed to identify current care pathways for people with Parkinson's (PwP) and elicit healthcare professionals' perspectives on how the introduction of SMaRT-PD would affect current care.MethodsTwelve semi-structured interviews with health care professionals working in the management and care of people with Parkinson's in NHS secondary or tertiary settings informed care pathway analysis and thematic analysis.ResultsParticipants described a care pathway which largely aligned with guidelines. Limitations of the existing care pathway included lengthy time to diagnosis, inconsistent care, staff shortages and challenges of appointment length and frequency. Participants outlined the potential advantages of introducing a home-based pathway including patient empowerment and education, earlier identification of patients who require an in-person review, and efficient use of clinic time. Perceived challenges to implementation of a home-based pathway were clinical and administrative. One concern was that patients and staff would miss regular face-to-face contact. A key evidence requirement for the adoption of SMaRT-PD was identified as demonstrable patient, carer and staff satisfaction.ConclusionsParticipants were generally supportive of introducing a home-based pathway for people with Parkinson's, suggesting that SMaRT-PD could provide an opportunity to direct limited resources to where they are most needed.