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Comparison of the Burdens and Attitudes Between Standard and Web-Based remote programming for Deep Brain Stimulation in Parkinson Disease: Survey Study

JMIR AGING

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JMIR AGING 2024年 7卷 e57503页

作者： Wan, Xiaonan Lin, Zhengyu Duan, Chengcheng Zeng, Zhitong Zhang, Chencheng Li, Dianyou Shanghai Jiao Tong Univ Ruijin Hosp Ctr Funct Neurosurg Dept NeurosurgSch Med 197 Ruijin Second RdYongjia Intersect Shanghai 200025 Peoples R China Shanghai Jiao Tong Univ Sch Med Ruijin Hosp Clin Neurosci Ctr Shanghai Peoples R China Shanghai Jiao Tong Univ Ruijin Hosp Clin Neurosci Ctr Luwan BranchSch Med Shanghai Peoples R China

Background: remote programming enables physicians to adjust implantable pulse generators over the internet for patients with Parkinson disease who have undergone deep brain stimulation (DBS) surgery. Despite these technological advances, the demand for and attitudes toward remote programming compared with standard programming among patients with Parkinson disease are still not well understood. Objective: This study aims to investigate the preferences and perceptions associated with these 2 programming methods among patients with Parkinson disease through a web-based survey. Methods: A web-based survey was administered to 463 patients with Parkinson disease who have undergone DBS surgery. The survey aimed to assess the burdens associated with postoperative programming and to compare patients' attitudes toward the 2 different programming methods. Results: A total of 225 patients completed the survey, all of whom had undergone standard programming, while 132 patients had also experienced remote programming. Among those who received standard programming, 191 (85%) patients required the support of more than 1 caregiver, 129 (58%) patients experienced over 2 days of lost work time, 98 (42%) patients incurred expenses ranging from US $42 to US $146, and 14 (6%) patients spent over US $421. Of the 132 patients who had used remote programming, 81 (62%) patients indicated a preference for remote programming in the future. However, challenges with remote programming persisted, including difficulties in obtaining official prescriptions, a lack of medical insurance coverage, and limited medical resources. Conclusions: Postoperative programming of DBS imposes significant burdens on patients and their caregivers during standard programming sessions-burdens that could be mitigated through remote programming. While patient satisfaction with remote programming is high, it is imperative for clinicians to develop personalized programming strategies tailored to the needs of different pa

关键词： remote programming Parkinson disease deep brain stimulation telemedicine economic evaluation

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remote programming of cardiac implantable electronic devices for MRI: Are we ready to change the channel?

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JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 2022年第5期33卷 1010-1012页

作者： Amaral, Ansel P. Montgomery, Jay A. Vanderbilt Univ Med Ctr Div Cardiovasc Med Nashville TN 37212 USA

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remote programming of cardiac implantable electronic devices: A novel approach to program cardiac devices for magnetic resonance imaging

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JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 2022年第5期33卷 1005-1009页

作者： Siddamsetti, Sisir Shinn, Alexander Gautam, Sandeep Univ Missouri Div Cardiovasc Med Columbia MO 65201 USA

Background Magnetic resonance imaging (MRI) in patients with MRI-conditional cardiovascular implantable electronic devices (CIED) remain a logistical issue for device programming during the scan. In current practice, a trained person needs to be present on-site to program CIED for MRI scan. This can cause delay in patient care, rescheduling of tests and increase healthcare costs. A novel remote programming (RP) strategy can be utilized to reprogram the CIED remotely. We sought to explore the feasibility and safety of RP of CIEDs in patients undergoing MRI scan. Methods We implemented the Medtronic CIED RP software at our institution after ensuring HIPAA compliance. The MRI technician started the session by contacting an off-site remote operator and placing a programmer wand from the 2090 Medtronic programmer over the CIED. The remote operator logged into a remote access software and provided a unique access code to the MRI technician. After entering the access code into the programmer, the remote operator was able to program the device as needed. We conducted a periodic audit of the first 209 patients who underwent RP of CIEDs for MRI. Outcomes analyzed were successful completion of RP sessions and time saved per scan. Results Of the 209 MRI scans, 51 scans were performed urgently. There were no connectivity and programming problems or need for MRI rescheduling. In-person reprogramming was not required for any patient. All scans were completed safely in a timely manner, and there were no reports of CIED malfunction. Time saved per scan was estimated to be 28 +/- 10 min. Conclusions remote programming of CIEDs for MRI scans is a safe and effective strategy.

关键词： CIED programming magnetic resonance imaging MRI MRI-conditional device remote monitoring remote programming

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Sink or Swim: Using remote programming to Manage a Very Australian Problem

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MOVEMENT DISORDERS CLINICAL PRACTICE 2025年第1期12卷 108-110页

作者： Helmi, Izyan Mohd Lehn, Alexander Princess Alexandra Hosp Dept Neurol Woolloongabba Qld Australia Queensland Univ Technol Fac Hlth Sch Biomed Sci Brisbane Qld Australia

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Comparing remote programming of cochlear implants using two methods: portable laptop and remote hosted site

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COCHLEAR IMPLANTS INTERNATIONAL 2024年第5期25卷 360-372页

作者： Ng, Amy H. C. Banh, Jessica Shaw, Laura Aboulhawa, Yasmeen Simone, Maria Le, Trung Lin, Vincent Chen, Joseph Sunnybrook Hlth Sci Ctr Otolaryngol Head & Neck Surg M1-1022075 Bayview Ave Toronto ON M4N 3M5 Canada Univ Toronto Dept Otolaryngol Toronto ON Canada

ObjectivesCompare two remote programming methods as a clinical service for user satisfaction, ease of use, preparation time and *** 1 (Portable Laptop): A 'programming Kit' including laptop was shipped to cochlear implant users' homes (N = 20). The audiologist at the implant center used remote desktop control of this laptop to adjust subjects' speech processors. Method 2 (remote Hosted Site): Eight distant clinics were recruited as host sites to house cochlear implant programming hardware and software so that CI users (N = 19) could attend their facility. The audiologist at the implant center used remote desktop control of the host sites' computers to adjust the subjects' CI speech processors. All parties were asked to fill out a questionnaire following their remote *** hosted site method was rated higher for ease of use by the remote Experts (12/15, 80%), compared to portable laptop method (11/19, 57.9%) and is more accessible to CI users of all levels of computer abilities while requiring less preparation time per *** hosted site method is an easier, more efficient method of remote programming as a clinical service delivery method compared to the Portable Laptop.

关键词： remote programming tele-mapping cochlear implants remote hosted sites remote expert local host

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Clinical use of real-time remote programming in pacemakers during the COVID-19 pandemic: A case report

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PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 2022年第6期45卷 815-817页

作者： Chen, Xu Liu, Han-Xiong Tong, Lin Yang, Si-Qi Qi, Ling-Yao Xiong, Shi-Qiang Luo, Yan Cai, Lin Southwest Jiaotong Univ Affiliated Hosp Peoples Hosp Chengdu 3 Dept Cardiol 82 Qinglong St Chengdu Sichuan Peoples R China

We report a case in which real-time remote interrogation and reprogramming of the parameters of a dual-chamber pacemaker was performed during the COVID-19 pandemic. The described case demonstrated the safety and effectiveness of CIED remote programming based on the 5G cloud technology support platform (5G-CTP), and showed that the application of real-time remote programming would help in reducing the risk of cross-infection between doctors and patients.

关键词： CIED COVID-19 follow-up remote programming ventricular pacing

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Management of Parkinson's disease patients after DBS by remote programming: preliminary application of single center during quarantine of 2019-nCoV

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JOURNAL OF NEUROLOGY 2021年第4期268卷 1295-1303页

作者： Xu, Jinyu Wang, Jiali Keith, Simfukwe Zhang, Mingyang Yang, Chunhui Yuan, Qing Qiu, Yiqing Hu, Xiaowu Wu, Xi Second Mil Med Univ Changhai Hosp Dept Neurosurg 168 Changhai Rd Shanghai 200433 Peoples R China Peoples Friendship Univ Dept Neurosurg Miklukho Maklaya Str 6 Moscow 111737 Russia Univ Utah Dept Chem 201 Presidents Cir Salt Lake City UT 84112 USA

IntroductionDeep brain stimulation (DBS) is an effective treatment for patients with Parkinson's disease (PD). On time follow-up and timely programing of symptoms are important measures to maintain the effectiveness of DBS. Due to the highly contagious nature of 2019-nCoV, patients were quarantined. With the help of Internet technologies, we continued to provide motor and non-motor symptom assessment and remote programming services for postsurgical PD-DBS patients during this extraordinary *** retrospective analysis was performed on postsurgical PD-DBS patients who could not come to our hospital for programming due to the impact of the 2019-nCoV. The differences between the pre- and post-programming groups were analyzed. We designed a 5-level Likert rating scale to evaluate the effects and convenience of the remote programming and Internet self-evaluation *** the 36 patients engaged in the remote programming, 32 patients met the inclusion criteria. Four of the 32 patients set initiated stimulation parameters, and the other 28 patients had significant improvement in UPDRS-III. Nearly all the 28 patients were satisfied with the effect of the remote programming. Most of the patients were willing to use remote programming *** programming based on the online evaluation of patient's symptoms can help improve motor symptoms of postsurgical DBS patients with PD during the quarantine period caused by 2019-nCoV.

关键词： Deep brain stimulation (DBS) Parkinson's disease (PD) remote programming 2019-nCoV Telemedicine

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The Use of remote programming for Spinal Cord Stimulation for Patients With Chronic Pain During the COVID-19 Outbreak in China

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NEUROMODULATION 2021年第3期24卷 441-447页

作者： Han, Yan Lu, Yang Wang, Dengyu Ran, Mingshan Ren, Qidong Xie, Duo Aziz, Tipu Z. Li, Luming Wang, James Jin Tsinghua Univ Sch Med Beijing Peoples R China Tsinghua Univ Beijing Tsinghua Changgung Hosp Sch Clin Med Dept Neurosurg Beijing Peoples R China Tsinghua Univ Sch Aerosp Engn Natl Engn Lab Neuromodulat Beijing 100085 Peoples R China Peking Univ Shougang Hosp Dept Rehabil Med Beijing Peoples R China Univ Oxford Nuffield Dept Surg Sci Oxford England Tsinghua Univ Tsinghua Berkeley Shenzhen Inst Precis Med & Healthcare Res Ctr Shenzhen Peoples R China Tsinghua Univ IDG McGovern Inst Brain Res Beijing Peoples R China Beijing Inst Brain Disorders Inst Epilepsy Beijing Peoples R China

Objectives Due to the impact of COVID-19 epidemic, face-to-face follow-up treatments for patients with chronic pain and implanted spinal cord stimulation (SCS) devices are forced to be delayed or stopped. This has led to more follow ups being done remotely. Meanwhile, with the development of 4G/5G networks, smartphones, and novel devices, remote programming has become possible. Here, we investigated the demand and utility of remote follow-ups including remote programming for SCS for patients with chronic pain. Materials and Methods A questionnaire including questions on demographic characteristics, pain history, postimplantation life quality, standard follow-up experience, remote follow-up, and remote programming experience was sent to patients diagnosed as chronic intractable pain and treated with SCS during January 2019 to January 2020. Results A total of 64 participants completed the questionnaire. About 70% of participants expressed demands for remote follow-ups due to the inconvenience, high costs, and time consumption of traditional follow-up visits. Nearly 97% of participants have attempted remote follow-ups, and about 81% of participants have further tried remote programming. Approximately, 96% of them recognized the benefits. Conclusions The remote programming was in high demand among participants. Most of the participants have tried remote follow-ups or even remote programming. The remote programming appeared to be more efficient, economic and were widely recognized among participants.

关键词： Chronic pain COVID-19 remote programming spinal cord stimulation telemedicine

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Precise management system for chronic intractable pain patients implanted with spinal cord stimulation based on a remote programming platform: study protocol for a randomized controlled trial (PreMaSy study)

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TRIALS 2023年第1期24卷 580-580页

作者： Cheng, Yuanchen Xie, Duo Han, Yan Guo, Siying Sun, Zhenxing Jing, Linkai Man, Weitao Liu, Dongkang Yang, Kaiyuan Lei, Dan Meng, Zhe Zhang, Huifang Wang, Guoqin Wu, Weiwei Wang, Guihuai Lu, Yang Tsinghua Univ Sch Med Beijing Peoples R China Air Force Med Ctr PLA Beijing Peoples R China Capital Med Univ Xuanwu Hosp Dept Neurol Beijing Peoples R China Tsinghua Univ Beijing Tsinghua Changgung Hosp Sch Clin Med Dept Neurosurg Beijing Peoples R China Tsinghua Univ Inst Precis Med Beijing Peoples R China

BackgroundSpinal cord stimulation (SCS) is a surgical technique used in patients with chronic intractable pain, and its effectiveness and safety have been validated by multiple studies. However, to maintain an optimal and steady long-term effect is still challenging. Here, we report a new management paradigm integrating smartphone application and remote programming. Chronic pain patients with SCS implants can monitor their pain status on the phone and change stimulation parameters accordingly. The PreMaSy study is a randomized controlled trial to evaluate the clinical effectiveness and safety of this precise management *** with chronic intractable pain will be screened for eligibility, and 82 participants are anticipated to be enrolled in this trial. After the electrode implantation, the stimulation effectiveness will be tested. Participants with a reduction of more than 50% in the visual analog scale (VAS) will receive implantation of an implantable pulse generator and randomized (1:1) into the experimental group or control group. All participants will be asked to take online follow-ups and complete assessments using a smartphone application. Daily pain characteristic assessments and monthly quality of life questionnaires are integrated into the App, and participants will be required to complete these assessments. The daily VAS for pain intensity will be monitored and a threshold will be set based on baseline VAS score. The interventional appointment will be scheduled once the threshold is reached. The primary outcome is the health condition and quality of life assessed by the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L). Utility values of EQ-5D-5L will be assessed at baseline and 1, 3, and 6 months *** PreMaSy study aims to evaluate the effectiveness and safety of a novel App-based, patient-centered, self-assessment management system for chronic intractable pain. A randomized controlled trial is designed

关键词： Chronic intractable pain Spinal cord stimulation remote programming Mobile health Randomized controlled trial Precision medicine

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Bridging the Gap remote Evaluation and programming of Cardiac Implantable Devices in Medically Underserved Areas

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JACC-CLINICAL ELECTROPHYSIOLOGY 2025年第1期11卷 171-178页

作者： Ploux, Sylvain Strik, Marc Varma, Niraj Bouteiller, Xavier Paul Carlier, Laetitia Lissandreau, Severine Ben Boujema, Terry Boursier, Damien Hugot, Estel Haissaguerre, Michel Benali, Karim Bordachar, Pierre Fdn Bordeaux Univ Electrophysiol & Heart Modeling Inst IHU Liryc Pessac France Bordeaux Univ Hosp CHU Cardiothorac Unit Pessac France Cleveland Clin Dept Cardiovasc Med Cleveland OH USA

BACKGROUND Delivering care in medically underserved areas (MUA) is a public health challenge. OBJECTIVES The purpose of this study was to evaluate the advantages of a noncommercial multivendor solution for remote interrogation and programming of cardiac implantable electronic devices (CIEDs) among inhabitants of MUAs. METHODS This prospective comparative study evaluated benefits and safety of remote CIEDs evaluation in patients living >100 km from the Bordeaux University Hospital. A conventional in-person evaluation at the Bordeaux hospital was compared with a remote evaluation performed 6 months later at a nurse office close to the patient home. The technical solution consisted of remote controlling CIED programmers from the 5 main manufacturers allowing evaluation of all kinds of CIEDs. RESULTS A majority of the 34 included patients (94%) were satisfied with the remote evaluation strategy. To attend the in-person evaluation at the Bordeaux Hospital, the patients covered a median distance of 253 km (ICR: 221-258 km) compared with 9 km (ICR: 6-19 km) (P < 0.001) to get to the nurse's office. The use of a medical vehicle was reduced by a factor 7 (44% vs 6%;P 1/4 0.001) with the remote evaluation, which translated into a reduction in the total traveling cost per patient by a factor 32 (96 Euros [87-268 Euros] vs 3 Euros [2-8 Euros];P < 0.001). The travel carbon footprint was 14 times lower (28 Kg CO2-eq [24-28 Kg CO2-eq] vs 2 Kg CO2-eq [1-5 Kg CO2-eq];P < 0.001) with the remote evaluation strategy. CONCLUSIONS remote evaluation of CIEDS in patients living MUA is feasible and safe. This approach is associated with a high level of satisfaction, lower economic and ecological costs compared with the in-person assessment in this population.

关键词： cardiac implantable electronic device Health Professional Shortage Areas implantable cardioverter-defibrillator medically underserved areas remote monitoring remote programming pacemaker telemedicine

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