Multidisciplinary care of patients with Parkinson's disease

Skelly, Robert; Lindop, Fiona; Johnson, Claire

doi:10.1002/pnp.230

Cited by 17 publications

(15 citation statements)

References 15 publications

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“…The study characteristics of 8 randomized, controlled trials (RCTs) included in the quantitative meta‐analysis and 19 other experimental studies included in the systematic review are presented in Table . The remaining 10 articles included in our systematic review were nonexperimental (ie, review articles or descriptions of care models) and are detailed separately in Supplementary Table 1 …”

Section: Resultsmentioning

confidence: 99%

“…The other major theme was delivery of multidisciplinary rehabilitation in various settings (n = 11) . Among the care coordination models, 24 were primarily based in the outpatient setting with or without care coverage extending to home or community . Two models were specifically tailored for perioperative evaluation of patients for deep brain stimulation, and another targeted neuropsychiatric symptoms in a comprehensive manner .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported the use of information technology–based platforms for the monitoring of patients’ day‐to‐day needs, coordination and feedback from the care provider, one utilized a telehealth solution . Other care coordination models used a ‘one‐stop‐clinic’ approach, where care providers from multiple domains met the patient at the same location over a day or two . Two models furthered this approach by taking health care provider teams to the patient's home .…”

Section: Resultsmentioning

confidence: 99%

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Integrated Care in Parkinson's Disease: A Systematic Review and Meta‐Analysis

et al. 2020

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Background Quality of life in Parkinson's disease (PD) is affected by motor and nonmotor symptoms, necessitating an integrated care approach. Existing care models vary considerably in numerous domains. The objectives of this study were to perform a systematic review and meta‐analysis of PD integrated care models and develop recommendations for a representative model. Methods We conducted a systematic review of published integrated care models and a meta‐analysis of randomized, controlled trials examining integrated care versus standard care. The primary outcome was health‐related quality of life using a validated PD scale. We evaluated levels of care integration using the Rainbow Model of Integrated Care. Results Forty‐eight publications were identified, including 8 randomized, controlled trials with health‐related quality of life data (n = 1,149 total PD patients). Qualitative evaluation of individual care model integration guided by the Rainbow Model of Integrated Care revealed frequent clinical and professional integration, but infrequent organizational and population‐based integration elements. Meta‐analysis of randomized, controlled trials revealed significant heterogeneity (I2 = 90%, P < 0.0001). Subgroup analysis including only outpatient care models (n = 5) indicated homogeneity of effects (I2 = 0%, P = 0.52) and improved health‐related quality of life favoring integrated care, with a small effect size (standardized mean difference [SMD], −0.17; 95% CI, −0.31 to −0.03; P = 0.02). Conclusions Outpatient integrated PD care models may improve patient‐reported health‐related quality of life compared with standard care; however, because of variable methodological approaches and a high risk of bias related to inherent difficulties in study design (eg, blinding of participants and interventionists), generalizability of these results are difficult to establish. The Rainbow Model of Integrated Care is a promising method of evaluating elements and levels of integration from individual patient care to population health in a PD context. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, LLC. on behalf of International Parkinson and Movement Disorder Society.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Integrated Care in Parkinson's Disease: A Systematic Review and Meta‐Analysis

et al. 2020

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“…In addition, effective management of psychological difficulties in PD also depends on early recognition and action (Shulman et al, 2002). One way to try and deliver this is through care being organised within a multidisciplinary approach (Skelly et al, 2012).…”

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confidence: 99%

“…Members of a multi-disciplinary team (MDT), for example, may include a neurologist, speech and language therapist, physiotherapist, an occupational therapist and a Parkinson's disease nurse specialist (PDNS) (Skelly et al, 2012). However, psychological difficulties in people with PD are often most likely to be recognised by PDNSs.…”

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confidence: 99%

Anxiety and depression in individuals with Parkinson's disease: perspectives of the nurse specialist

Theed

Eccles

Travers

et al. 2016

British Journal of Neuroscience Nursing

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Aim: Parkinson's disease (PD) is a neurodegenerative disease, most usually associated with motor problems, although psychological difficulties are also commonly experienced. In the UK Parkinson's disease nurse specialists (PDNSs) are often the key healthcare professionals involved in the management of PD, with regards to both the motor and psychological aspects of PD. This qualitative study sought to investigate the experiences of Parkinson's disease nurse specialists (PDNSs) in recognising and managing psychological difficulties in people with PD. Design: Five female participants-four PDNSs and one neurology nurse specialising in PDfrom the North West of England took part in the study. Participants were all female and had been in their roles for between 2.5 and 14 years. The study used a qualitative methodology aimed at providing a detailed account and analysis. Method: Individual semi-structured interviews were conducted and subsequently analysed using thematic analysis. Results: Five overarching themes were developed summarising participants' experiences. These included understanding the causes of psychological difficulties; accessing psychological support; the recognition and management of psychological difficulties; the improvement of psychological care and the personal resilience of the nurse specialists. Conclusions: The specialist nurses were closely involved in the assessment and support of anxiety and depression of people with PD but concerns were expressed that there were limited resources for further help and management.

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Clinical features associated with drooling in Parkinson’s disease

Nascimento

2021

Neurol Sci

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Multidisciplinary care of patients with Parkinson's disease

Cited by 17 publications

References 15 publications

Integrated Care in Parkinson's Disease: A Systematic Review and Meta‐Analysis

Integrated Care in Parkinson's Disease: A Systematic Review and Meta‐Analysis

Anxiety and depression in individuals with Parkinson's disease: perspectives of the nurse specialist

Clinical features associated with drooling in Parkinson’s disease

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