title: National Randomized Controlled Trial of Virtual House Calls for People with Parkinson's Disease: Interest and Barriers.
abstract: Delivering specialty care remotely directly into people's homes can enhance access for and improve the healthcare of individuals with chronic conditions. However, evidence supporting this approach is limited.
  
  
  
  Connect.Parkinson is a randomized comparative effectiveness study that compares usual care of individuals with Parkinson's disease in the community with usual care augmented by virtual house calls with a Parkinson's disease specialist from 1 of 18 centers nationally. Individuals in the intervention arm receive four virtual visits from a Parkinson's disease specialist over 1 year via secure, Web-based videoconferencing directly into their homes. All study activities, including recruitment, enrollment, and assessments, are conducted remotely. Here we report on interest, feasibility, and barriers to enrollment in this ongoing study.
  
  
  
  During recruitment, 11,734 individuals visited the study's Web site, and 927 unique individuals submitted electronic interest forms. Two hundred ten individuals from 18 states enrolled in the study from March 2014 to June 2015, and 195 were randomized. Most participants were white (96%) and college educated (73%). Of the randomized participants, 73% had seen a Parkinson's disease specialist within the previous year.
  
  
  
  Among individuals with Parkinson's disease, national interest in receiving remote specialty care directly into the home is high. Remote enrollment in this care model is feasible but is likely affected by differential access to the Internet.
authors.affiliation: 1 Department of Neurology, Rochester, New York.|2 CHET, University of Rochester Medical Center , Rochester, New York.
authors.forename: E Ray
authors.initials: ER
authors.lastname: Dorsey
authors.affiliation: 3 Duke University School of Medicine , Durham, North Carolina.
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Achey
authors.affiliation: 4 Department of Biostatistics, University of Rochester , Rochester, New York.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Beck
authors.affiliation: 5 National Parkinson Foundation , Miami, Florida.
authors.forename: Denise B
authors.initials: DB
authors.lastname: Beran
authors.affiliation: 1 Department of Neurology, Rochester, New York.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Biglan
authors.affiliation: 6 Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Boyd
authors.affiliation: 5 National Parkinson Foundation , Miami, Florida.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Schmidt
authors.affiliation: 7 Simone Consulting , Sunnyvale, California.
authors.forename: Richard
authors.initials: R
authors.lastname: Simone
authors.affiliation: 8 Department of Neurology, Philadelphia, Pennsylvania.|9 Department of Biostatistics and Epidemiology, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Allison W
authors.initials: AW
authors.lastname: Willis
authors.affiliation: 10 Department of Neurology, University of California San Francisco , San Francisco, California.
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Galifianakis
authors.affiliation: 10 Department of Neurology, University of California San Francisco , San Francisco, California.
authors.forename: Maya
authors.initials: M
authors.lastname: Katz
authors.affiliation: 10 Department of Neurology, University of California San Francisco , San Francisco, California.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Tanner
authors.affiliation: 10 Department of Neurology, University of California San Francisco , San Francisco, California.
authors.forename: Kristen
authors.initials: K
authors.lastname: Dodenhoff
authors.affiliation: 10 Department of Neurology, University of California San Francisco , San Francisco, California.
authors.forename: Nathan
authors.initials: N
authors.lastname: Ziman
authors.affiliation: 11 Northwest Neurological, PLLC , Spokane, Washington.
authors.forename: Jason
authors.initials: J
authors.lastname: Aldred
authors.affiliation: 12 Parkinson Center and Movement Disorders Program, Oregon Health and Science University , Portland, Oregon.
authors.forename: Julie
authors.initials: J
authors.lastname: Carter
authors.affiliation: 13 Department of Neurology, Baylor College of Medicine , Houston, Texas.
authors.forename: Joohi
authors.initials: J
authors.lastname: Jimenez-Shahed
authors.affiliation: 13 Department of Neurology, Baylor College of Medicine , Houston, Texas.
authors.forename: Christine
authors.initials: C
authors.lastname: Hunter
authors.affiliation: 8 Department of Neurology, Philadelphia, Pennsylvania.
authors.forename: Meredith
authors.initials: M
authors.lastname: Spindler
authors.affiliation: 14 Department of Neurology and Neurosurgery, Johns Hopkins University , Baltimore, Maryland.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Mari
authors.affiliation: 15 Department of Neurology, Georgia Regents University , Augusta, Georgia .
authors.forename: John C
authors.initials: JC
authors.lastname: Morgan
authors.affiliation: 15 Department of Neurology, Georgia Regents University , Augusta, Georgia .
authors.forename: Dedi
authors.initials: D
authors.lastname: McLane
authors.affiliation: 16 Department of Neurology, Duke Medical Center , Durham, North Carolina.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hickey
authors.affiliation: 16 Department of Neurology, Duke Medical Center , Durham, North Carolina.
authors.forename: Lisa
authors.initials: L
authors.lastname: Gauger
authors.affiliation: 1 Department of Neurology, Rochester, New York.
authors.forename: Irene Hegeman
authors.initials: IH
authors.lastname: Richard
authors.affiliation: 1 Department of Neurology, Rochester, New York.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Bull
authors.affiliation: 17 Department of Neurology, Massachusetts General Hospital , Boston, Massachusetts.
authors.forename: Nicte I
authors.initials: NI
authors.lastname: Mejia
authors.affiliation: 17 Department of Neurology, Massachusetts General Hospital , Boston, Massachusetts.
authors.forename: Grace
authors.initials: G
authors.lastname: Bwala
authors.affiliation: 18 Struthers Parkinson's Center , Golden Valley, Minnesota.
authors.forename: Martha
authors.initials: M
authors.lastname: Nance
authors.affiliation: 19 Department of Neurology, Beth Israel Deaconess Medical Center , Boston, Massachusetts.
authors.forename: Ludy
authors.initials: L
authors.lastname: Shih
authors.affiliation: 19 Department of Neurology, Beth Israel Deaconess Medical Center , Boston, Massachusetts.
authors.forename: Lauren
authors.initials: L
authors.lastname: Anderson
authors.affiliation: 20 Department of Neurology, University of Miami , Miami, Florida.
authors.forename: Carlos
authors.initials: C
authors.lastname: Singer
authors.affiliation: 21 Department of Neurology, Northwestern University , Evanston, Illinois.
authors.forename: Cindy
authors.initials: C
authors.lastname: Zadikoff
authors.affiliation: 21 Department of Neurology, Northwestern University , Evanston, Illinois.
authors.forename: Natalia
authors.initials: N
authors.lastname: Okon
authors.affiliation: 22 The Feinstein Institute for Medical Research, North Shore-LIJ Health System , Manhasset, New York.
authors.forename: Andrew
authors.initials: A
authors.lastname: Feigin
authors.affiliation: 22 The Feinstein Institute for Medical Research, North Shore-LIJ Health System , Manhasset, New York.
authors.forename: Jean
authors.initials: J
authors.lastname: Ayan
authors.affiliation: 23 Department of Neurology, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: Christina
authors.initials: C
authors.lastname: Vaughan
authors.affiliation: 24 Department of Neurology, University of Kansas Medical Center , Kansas City, Kansas.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Pahwa
authors.affiliation: 24 Department of Neurology, University of Kansas Medical Center , Kansas City, Kansas.
authors.forename: Jessica
authors.initials: J
authors.lastname: Cooper
authors.affiliation: 24 Department of Neurology, University of Kansas Medical Center , Kansas City, Kansas.
authors.forename: Sydney
authors.initials: S
authors.lastname: Webb
authors.affiliation: 25 Parkinson's Institute , Sunnyvale, California.
authors.forename: Rohit
authors.initials: R
authors.lastname: Dhall
authors.affiliation: 26 Department of Neurology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Anhar
authors.initials: A
authors.lastname: Hassan
authors.affiliation: 26 Department of Neurology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Delana
authors.initials: D
authors.lastname: Weis
authors.affiliation: 27 Center for Information Technology Research in the Interest of Society, University of California , Berkeley, California.
authors.forename: Steven
authors.initials: S
authors.lastname: DeMello
authors.affiliation: 28 Health Informatics Centre, Karolinska Institute , Stockholm, Sweden .
authors.forename: Sara S
authors.initials: SS
authors.lastname: Riggare
authors.affiliation: 29 PatientsLikeMe, Cambridge, Massachusetts .
authors.forename: Paul
authors.initials: P
authors.lastname: Wicks
authors.affiliation: 30 West Health Institute , La Jolla, California.
authors.forename: Joseph
authors.initials: J
authors.lastname: Smith
authors.affiliation: 2 CHET, University of Rochester Medical Center , Rochester, New York.
authors.forename: H Tait
authors.initials: HT
authors.lastname: Keenan
authors.affiliation: 2 CHET, University of Rochester Medical Center , Rochester, New York.
authors.forename: Ryan
authors.initials: R
authors.lastname: Korn
authors.affiliation: 1 Department of Neurology, Rochester, New York.
authors.forename: Heidi
authors.initials: H
authors.lastname: Schwarz
authors.affiliation: 2 CHET, University of Rochester Medical Center , Rochester, New York.
authors.forename: Saloni
authors.initials: S
authors.lastname: Sharma
authors.affiliation: 2 CHET, University of Rochester Medical Center , Rochester, New York.
authors.forename: E Anna
authors.initials: EA
authors.lastname: Stevenson
authors.affiliation: 2 CHET, University of Rochester Medical Center , Rochester, New York.
authors.forename: William
authors.initials: W
authors.lastname: Zhu
mesh_terms: D005240:Feasibility Studies; D006792:House Calls; D006801:Humans; D020407:Internet; D010300:Parkinson Disease / Q000628:therapy*; D019114:Remote Consultation / Q000458:organization & administration*; D012107:Research Design; D012959:Socioeconomic Factors; D049269:Videoconferencing
keywords: Parkinson's disease; access to care; chronic conditions; home healthcare; randomized controlled trial; specialists; telemedicine; videoconferencing