Home-Based Titration with Duodenal Infusion of Levodopa-Carbidopa Intestinal Gel in People with Parkinson’s Disease: An Observational Feasibility Study
Table 2
Classification of facilitators, barriers, and a PwP profile in implementing an HBT program.
Facilitators
(i) An HBT program is feasible due to the length of the titration period, the number of contacts to MDC, and the time spent in private homes
(ii) Timeframe of 3–4 days of home titration is sufficient
(iii) The HBT program is experienced as safe for PwPs and caregivers as long as they have a “hotline” to MDC/support nurses and TM assistance when needed
(iv) Caregivers are primary decision-makers and hold the responsibility during the titration process, which is why they must be actively involved and informed during the process
(v) An environment for a daily and close dialog between the HCP members in the PD team is recommended
Barriers
(i) Technical improvements in the TM system and earlier introduction should be considered to improve digital competencies of PwPs and caregivers
(ii) The program has to be established with educational initiatives for all parties: PwPs, caregivers, and cross-sectoral HCPs in primary care before starting
(iii) A vast amount of responsibility is placed on the caregivers, which must be mitigated by support from the PD team and the support nurse
PwP profile eligible for HBT
(i) Cognition is not a vital parameter if the PwP has a caregiver, who is healthy and motivated to participate
(ii) Living at home or in nursing home (more education to HCPs in primary care is needed)
(iii) Capable of managing a TM system
(iv) Are motivated and feel safe with home treatment
(v) No severe side effects of LCIG (hallucinations and psychosis)
