PD_manager is an mHealth platform for the monitoring and management of patients suffering from Parkinson’s. "It is the first of its kind," says project coordinator Dr. Dragana Miljkovic.

Graphic displaying user interaction for PD_manager project

Parkinson’s disease (PD) is a complex chronic disease that most people live with for many years. More than one million people live with PD in Europe today and this number is forecast to double by 2030. Also, there are predictions that by 2020 the number of diagnosed patients will be more than 12 million worldwide.

Due to the complexity of the disease, multidisciplinary management involving several professions working together (neurologists, psychologists, physiotherapists, speech and language therapists, occupational therapists, dieticians) is important to ensure that the patient retains his/her independence and continues to have the best quality of life possible.

With this in mind, the experts of the PD_manager project, funded under the Horizon 2020 programme, have been building and evaluating an innovative mHealth ecosystem for PD management.

Shoe insoles, smartwatch and smartphone

"The innovative part of the project is its holistic approach to disease management," says project coordinator Dr. Dragana Miljkovic (Jožef Stefan Institute in Ljubljana, Slovenia). "More specifically, it uses a set of mobile and wearable devices - smartwatch, smartphone and sensor insoles - for symptoms monitoring and collection of adherence data."

Dr. Miljkovic: "With these data, you can assess motor and non-motor symptoms in Parkinson’s patients. Moreover, we adressed nutrition and physiotherapy aspects by conducting a dedicated nutritional study and developing game-based physiotherapy at home. The behaviour of patients, caregivers, neurologists and other health-care providers are also monitored."

Finally, the project provides personalised suggestions for an optimal PD management plan, adopts an open architecture to support any commercial set of sensors within an Internet of Things concept and educates patients, caregivers and healthcare providers with a focus on occupational and speech therapies.

Positive feedback

PD_Manager started by defining system specifications. It ran several studies on user needs, usability, acceptability, ethics, etc. Moreover, initial nutrition and gamification experiments were performed.

"Based on these and other data, we built data mining and decision support models," says Dr. Miljkovic. "These models are being tested in a Big Pilot study currently held on 200 patients (100 controls and 100 using PD_manager) across four hospitals in Italy, Greece and UK. The initial feedback from patients and clinicians after the first phase of project has been encouraging and positive."

Dr. Miljkovic: "The PD_manager project has been an extremely challenging project involving experts from various fields: neurologists, psychiatrists, psychologists, mobile apps programmers, software engineers, data miners, decision support experts, etc. The study was coordinated by the Jožef Stefan Institute in Ljubljana while the technical aspects were supervised by the Unit of Medical Technology and Intelligent Information Systems of the University of Ioannina. The rest of the technical partners supported successful implementation of the PD_manager platform: Moticon (Germany), B3D (UK), Synthema (Italy) and University of Madrid. The clinical partners are the IRCCS San Camillo Hospital of Venice, IRCCS Santa Lucia in Rome, the Neurology Clinic of the University Ioannina (Greece), the Rehabilitation University Center of Ljubljana (Slovenia) and University of Surrey (UK). All members from the project consortium highly cooperative and I cannot thank them enough for their devotion to our team work."

"We are ending our project successfully in 6 months," says Dr. Miljkovic: "We are currently exploring possibilities for another round of funding to finalise our platform and bring it even closer to the market, a result we are all eager to achieve." .