Abstract
BACKGROUND: Social distancing during the COVID-19 pandemic affected follow-up visits and medication availability for patients with Parkinson's disease (PD). As a promising strategy to deal with these challenges, the implementation of health management smartphone apps was accelerated. However, whether more intense use of such apps could improve the quality of life (QoL) for PD patients during the COVID-19 pandemic was unknown. METHODS: Using a PD management app, this observational study assessed changes in QoL, as determined by PD Questionnaire 8 (PDQ-8), among PD patients before (Jan 20, 2019 to Oct 6, 2019) and after the beginning of the COVID-19 lockdown (Jan 20, 2020 to Oct 6, 2020). According to adherence to use of the app, participants were divided into low adherence, moderate adherence, and high adherence groups. A total of 4979 PD patients registered in the app, and 226 PD patients were enrolled, including 57 patients with low adherence, 112 with moderate adherence and 57 with high adherence. A generalized linear model was used to evaluate the change of PDQ-8 scores across these three different adherence groups. RESULTS: After the COVID-19 lockdown (1-year follow-up), the PDQ-8 scores are reduced by 0.8 (95% CI, 0.3-1.4) in all participants (P = 0.004). After adjustment for age, gender, education, disease duration and levodopa equivalent dose, PDQ-8 scores significantly less reduced in the high adherence group (0.3; 95% CI, 0.6-1.2) compared to the low adherence (1.9; 95% CI, 0.7-3.1) (P = 0.040) and moderate adherence groups (0.6; 95% CI, 0.2-1.3) (P = 0.012). CONCLUSIONS: A health management smartphone-based app might be a way to both measure and improve QoL among PD patients, provided that sufficient adherence is achieved.