PDPlus - Movement Diary

Parkinson’s Disease is a neurodegenerative disease which causes reduction of dopamine levels in the brain. Since dopamine is important in muscular control, Parkinson's disease typically manifests as abnormal movements, such as
- Tremor
- Rigidity
- Bradykinesia
- Truncal Instability
- Freezing of Gait

Patients who have had Parkinson's disease for a long period tend to be less responsive to medications, or might respond to medications more unpredictably. Examples include medications wearing off sooner than expected, symptoms of dyskinesia, and medications having slower than expected onset. Patients with longstanding Parkinson's disease also are more susceptible to medication side effects, such as nausea/vomiting, dyskinesia, and hallucinations.


Effective care of patients with advanced Parkinson's disease requires good cooperation from both the patient and their relatives and caregivers. Evaluation of efficacy and satisfaction of a patient's current medications can be subjective and difficult to communicate verbally in a simple outpatient visit. –– These days, some patients are prescribed what is called a "Patient's Diary", which is used for them to record their symptoms during the day, along with side effects of the medications. This helps the clinician identify which medications to adjust for which time of day more accurately.

However, usage of a physical Patient's Diary is quite limiting
- The patient needs to carry around a physical, paper item, which could get damaged
- Having to record symptoms during the whole day is inconvenient
- Some patients get tired of recording and give up. This causes incomplete data.
- Medications listed in the physical diary may not be kept up to date, and may be incorrect
- Or even limitations at the clinician side. Enormous amounts of paper data at once after a long period between follow ups may be inconvenient to analyze and make deductions from.

Currently, Parkinson's disease is not curable, and there is currently no possible way for diagnosis until symptoms start showing. Current researches are trying to identify potential ways of diagnosis before symptoms start showing, and to find medications or other treatment that may modify and/or delay the course of the disease. King Chulalongkorn Memorial Hospital is a tertiary hospital and medical school, and this project is one of the many steps we are taking towards a more patient-centric care.

PDPlus application (or Parkinson's Plus) is created with the support of the Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders division of the Neurology Department at King Chulalongkorn Memorial Hospital. This is used as an electronic substitute to the Patient Diary, with a more simplified interface. This allows patients to be able to record their symptoms during the day using a device they already carry around (smartphones & tablet), and the data is immediately synchronized with physicians, and easily visualized and summarized. This allows for a streamlined experience for both physicians and patients. Furthermore, medication data is synchronized with outpatient visit prescriptions at the Movement clinic, reducing the risk of incorrect medications. Other minor benefits include medication reminders, and some selected physical exams for select patients to perform, which can further aid in patient care.

Features
- Recording of patient states (On / Off / Dyskinesia)
- Medication reminder
- Medication summary & Summary of medication compliance
- Selected physical examinations for self evaluation & for research patients

This application is part of a project by the Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders at King Chulalongkorn Memorial Hospital. For more information, please contact Line ID @ChulaPD