Diverse preferences, different solutions: Exploring remote monitoring preferences in Parkinson's disease through a discrete choice experiment

Background Remote monitoring solutions (RMS) have the potential to improve Parkinson's disease (PD) management by enabling continuous symptom tracking and personalized care. Understanding patient preferences for RMS features is essential for successful implementation. Objective This study aimed to investigate the preferences of people with Parkinson's disease (PwP) for RMS features and identify preference heterogeneity across distinct patient subgroups. Methods From November 2023 to February 2024, a discrete choice experiment (DCE) was conducted among PwP in Finland and Italy to elicit preferences for RMS attributes, including monitoring frequency, time spent filling questionnaires, home video recordings, and clinical benefits (delay in advanced symptom onset). Latent class analysis (LCA) was used to identify subgroups with distinct preference patterns, and adoption probabilities under varying RMS scenarios were estimated. Results A total of 411 PwP participated, revealing significant heterogeneity in RMS preferences. While clinical benefits, particularly delaying advanced symptom onset, were the most valued attribute overall, preferences diverged across subgroups. Some participants strongly preferred home video recordings, whereas others expressed aversion to this feature. A smaller subgroup exhibited reluctance toward RMS adoption, regardless of its benefits. Conclusions PwP generally view RMS favorably, but preferences for specific features vary substantially across subgroups. Clinical benefits are a key driver of adoption, while home video recordings elicit both strong preference and aversion, highlighting the impracticality of a one-size-fits-all approach. Tailoring RMS to diverse patient needs, addressing concerns, and enhancing usability through customization are essential for successful implementation and widespread acceptance in PD management.