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Erschienen in: Journal of Neurology 4/2018

01.02.2018 | Original Communication

Patient-centered integrated healthcare improves quality of life in Parkinson’s disease patients: a randomized controlled trial

verfasst von: Carsten Eggers, R. Dano, J. Schill, G. R. Fink, M. Hellmich, L. Timmermann, On behalf of the CPN study group

Erschienen in: Journal of Neurology | Ausgabe 4/2018

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Abstract

Introduction

Improving quality of life (QoL) is a key issue when dealing with Parkinson’s disease (PD). Integrative care shows potential to achieve improvements in QoL. Here, we analyzed whether a community-based, open-label, integrated approach improves QoL in PD patients.

Methods

PD patients were screened for eligibility and evaluated by a university-based PD specialist, a PD nurse, and a general neurologist at a local practice. Patients were randomly assigned to a control group (CG), receiving standard German neurological treatment including a baseline assessment and follow-up visit at 6 months, or an interventional group (IG) who received an individually tailored therapy plan and additional home visits. Patients and investigators were not blinded for either intervention. Primary outcome analysis compared the differential change of PDQ-39 from baseline to 6-month follow-up between CG and IG. Between-group changes in mood, motor/non-motor functioning, and cognition were secondary outcomes.

Results

300 patients were included and randomized equally to IG and CG. 132 IG and 125 CG patients had a valid PDQ-39 at follow-up and qualified for the modified ITT analysis. PDQ-39 improved more in IG compared to CG [2.2 points (95% CI − 4.4 to 0.1); p = 0.044]. Likewise, change scores between IG and CG favored IG for UPDRS III (p < 0.001, mean change 3.3, 95% CI − 4.9 to − 1.7) and PD-NMS (p < 0.001, mean change 11.3, 95% CI − 17.1 to − 5.5).

Conclusions

Data show that an integrated approach, compared to regular PD care, improves QoL as well as motor and nonmotor PD symptoms over 6 months. Future studies need to address the cost–benefit ratio and whether positive effects can be maintained beyond intervention.
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Metadaten
Titel
Patient-centered integrated healthcare improves quality of life in Parkinson’s disease patients: a randomized controlled trial
verfasst von
Carsten Eggers
R. Dano
J. Schill
G. R. Fink
M. Hellmich
L. Timmermann
On behalf of the CPN study group
Publikationsdatum
01.02.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 4/2018
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-018-8761-7

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