Transforming Parkinson's disease clinical management with integrated digital health technologies
Lead Research Organisation:
University of Manchester
Department Name: Chem Eng and Analytical Science
Abstract
Parkinson's disease (PD) is an incurable and progressive neurological disorder, which is growing fast in prevalence due to an ageing population. The problem is that the effect of Levodopa (L-dopa), the standard drug used to treat PD, wears off after ~90 min. In addition, the drug's therapeutic effect is limited since only 1-5% of L-dopa reaches the brain. Therefore, medication levels fluctuate significantly and patients require multiple L-dopa doses over a 24-h period.
When medication is working, patients experience significant improvement of their PD symptoms which include stiffness, slowness, and tremors. However, at low medication levels patients experience "off periods" and high medication levels result in debilitating uncontrolled movements. As PD progresses, "off periods" become more frequent (typically 2-5h/day) and patients lose critical function such as speech and mobility. At this stage patients are fully reliant on carers or healthcare personnel, leading to high incidence of depression and substantial out-of-pocket expenditure for care.
There are some wearable devices on the market to remind PD patients when to take medication but their functionality is limited. In this proposal, we will develop a package of digital tools for the remote monitoring and improved clinical management of PD. This will comprise wearables that can monitor the mobility and motor symptoms of PD patients and a device that can monitor in real-time levels of L-dopa by measuring interstitial fluid, the fluid just below the skin. Algorithms and software will be developed to replace the current rigid "one-size-fits-all" medication regime with adaptive, personalized medication levels.
In the future, we will integrate these digital tools to have a single wearable device that can determine the optimized drug regime for PD patients. This platform is unique because it can measure both medication levels and symptoms in real-time from the comfort of the patient's home. It will bring significant benefits to PD patients by improving their medication adherence, better informed clinical-decision making, and improving their independence by reducing length and frequency of "off periods".
We will work closely with patients, carers, clinicians, and local policy makers to ensure the intended wearable is fit for the purpose. In the future, it is envisaged that this platform can be extended to monitoring of other therapeutics and will improve medication adherence for patients managing multiple (chronic) conditions.
When medication is working, patients experience significant improvement of their PD symptoms which include stiffness, slowness, and tremors. However, at low medication levels patients experience "off periods" and high medication levels result in debilitating uncontrolled movements. As PD progresses, "off periods" become more frequent (typically 2-5h/day) and patients lose critical function such as speech and mobility. At this stage patients are fully reliant on carers or healthcare personnel, leading to high incidence of depression and substantial out-of-pocket expenditure for care.
There are some wearable devices on the market to remind PD patients when to take medication but their functionality is limited. In this proposal, we will develop a package of digital tools for the remote monitoring and improved clinical management of PD. This will comprise wearables that can monitor the mobility and motor symptoms of PD patients and a device that can monitor in real-time levels of L-dopa by measuring interstitial fluid, the fluid just below the skin. Algorithms and software will be developed to replace the current rigid "one-size-fits-all" medication regime with adaptive, personalized medication levels.
In the future, we will integrate these digital tools to have a single wearable device that can determine the optimized drug regime for PD patients. This platform is unique because it can measure both medication levels and symptoms in real-time from the comfort of the patient's home. It will bring significant benefits to PD patients by improving their medication adherence, better informed clinical-decision making, and improving their independence by reducing length and frequency of "off periods".
We will work closely with patients, carers, clinicians, and local policy makers to ensure the intended wearable is fit for the purpose. In the future, it is envisaged that this platform can be extended to monitoring of other therapeutics and will improve medication adherence for patients managing multiple (chronic) conditions.
Related Projects
| Project Reference | Relationship | Related To | Start | End | Award Value |
|---|---|---|---|---|---|
| EP/W031590/1 | 10/01/2023 | 30/11/2023 | £403,409 | ||
| EP/W031590/2 | Transfer | EP/W031590/1 | 01/01/2024 | 29/06/2025 | £150,383 |
| Description | We have discovered that keeping medication levels for Parkinson's disease patients with a certain range has a significant impact on their quality of life, as evidenced via questionnaires and discussion with patients and carers via focus groups. There is a high demand for a disease that can actually measure levels of levodopa, the medication used by patients, and we are in the process of developing such a device. |
| Exploitation Route | The platform we have developed might be employed to monitor levels of other medications and therefore this wearable device will be of significant benefit to patients with (multiple) chronic conditions as it will significantly improve their independence at home. |
| Sectors | Communities and Social Services/Policy Education Pharmaceuticals and Medical Biotechnology |
| Description | We have held more focus groups for patients with Parkinson's disease and are currently in the process of writing a report on this information which will be disseminated via charities. |
| First Year Of Impact | 2024 |
| Sector | Communities and Social Services/Policy,Education,Pharmaceuticals and Medical Biotechnology |
| Impact Types | Societal |
| Description | Technology nEtwork for Social Care Innovation (formation of new network) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Other audiences |
| Results and Impact | As part of our activity in this area, I was invited to a working group called "Technology nEtwork for Social Care Innovation" - a new network which we aim to set up via UKRI. This network involved third party organisations in the social care sector (which includes care for patients with PD) and a range of academics who have previously been funded in similar. The working group comprised around 20 people who came together to put forward a proposal on how technologies, such as this one, can revolutionised social care. |
| Year(s) Of Engagement Activity | 2024 |