Recommendations for people with Parkinson’s disease (PD) include increased physical activity and socialization in order to help manage common stress-related mood diseases such as anxiety and depression. However, in light of the COVID-19 pandemic, public health measures have drastically impacted social interactions through the implementation of social distancing and of travel restrictions, and the cancellation of in-person activities, such as exercise programs. These measures have also led to changes in the delivery of healthcare. This recent study by Feeney et al. explores the impacts of public health strategies on the health and daily routine of people with PD.
In the survey, which was based in the United States, people with PD and their care partners answered questions regarding their demographics and the perceived impact of the pandemic on their health and on the methods through which they received healthcare during the first 3 months of the pandemic. About half of the respondents reported negative changes in their PD symptoms since the onset of the pandemic.
Nearly half of people with PD reported reduced exercise time since the beginning of the pandemic, with a total of 72.9% reporting reduced activities outside of their homes. Thankfully, most reported that these activities (support groups, fitness classes, educational events, etc.) were offered online. Many respondents reported taking extra precautions during the pandemic such as cancelling or postponing appointments or activities, avoiding public spaces such as restaurants and picking up 3-month refills for their medications.
The pandemic affected the mood of people with PD as 66.5% of respondents reported feeling nervous or anxious, 50.9% noticed feeling down or depressed, while 53.7% had reduced pleasure or interest in doing things in the 6 weeks leading up to the survey. Many reported COVID-related anxieties such as the fear of getting infected, worries about the unknowns of the pandemic, depression related to decreased contact with friends and family, and loss of interest due to not being allowed to leave their homes.
Prior to the pandemic, only 9.7% of respondents reported having received medical care through telemedicine (which includes medical visits through video and phone calls), while this figure went up to 63.5% upon completion of the survey, which was administered between May and June 2020. Telemedicine use correlated with higher education and socioeconomic status. Virtual appointments were more often used for appointments with doctors or medical providers than other forms of healthcare such as speech, occupational, physical and mental health therapies. Of those who used telemedicine programs, 67.2% of respondents reported being equally or more satisfied with their telemedicine visit compared to in-person doctor’s appointments, while 46% expressed the willingness to continue using virtual healthcare always or sometimes after the end of the pandemic. Those who had received instructions and assistance upon their telehealth appointment were more likely to be in favour of continued virtual appointments after the pandemic.
This study highlights the important role of telemedicine in modern healthcare administration but also points to the importance of providing patients with instructions and support prior to and during virtual appointments. This is particularly important for people who may not be as familiar with technology. Telemedicine programs should aim to better assist patients of lower socioeconomic status and education levels, and should be offered for a wider range of healthcare services, rather than mainly doctor’s appointments. Allowing patients with PD to have these appointments from home would increase accessibility to these services, and would likely improve patients’ wellbeing.
References
Feeney, M. P., Xu, Y., Surface, M., Shah, H., Vanegas-Arroyave, N., Chan, A. K., . . . Alcalay, R. N. (2021). The impact of COVID-19 and social DISTANCING on people with PARKINSON’S disease: A survey study. Npj Parkinson's Disease, 7(1). doi:10.1038/s41531-020-00153-8