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A Comprehensive Approach to Care in Parkinson's Disease Adds Quality to the Current Gold Standard
Author(s) -
Vaughan Camille P.,
Prizer Lindsay P.,
Vandenberg Ann E.,
Goldstein Felicia C.,
Trotti Lynn Marie,
Hermida Adriana P.,
Factor Stewart A.
Publication year - 2017
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12508
Subject(s) - medicine , physical therapy , specialty , gold standard (test) , rating scale , quality of life (healthcare) , parkinson's disease , neurology , disease , marital status , randomized controlled trial , family medicine , psychology , psychiatry , nursing , population , developmental psychology , environmental health
Background Providing high‐quality care for patients with Parkinson's disease ( PD ) involves addressing both motor and nonmotor features. We describe the implementation and evaluation of a 2‐day, interdisciplinary Comprehensive Care Clinic ( CCC ) for patients with PD . Methods Patients who attended the CCC between January 2010 and July 2013 were matched by sex and age with patients who were evaluated in specialist care during the same time frame. Provider documentation of the American Academy of Neurology ( AAN ) quality measures for PD and Unified Parkinson's Disease Rating Scale ( UPDRS ) motor scores were compared between specialist and CCC visits at baseline and at 12 months. Results Ninety‐five patients participated in the CCC (60% men; 75% white; mean age, 68 years; age range, 38–97 years). Of these, 29 patients were matched to specialist care patients based on the availability of 12‐month follow‐up data. Both groups were similar with respect to race, marital status, years with PD , and baseline UPDRS motor scores. On average, patients who received CCC care met 10 of 10 AAN quality measures, whereas those who received specialist care met only 5 of 10 quality measures ( P < 0.001) over 12 months. At 12‐months, there were no significant differences in UPDRS motor scores between the groups ( P = 0.5). Conclusions According to the AAN quality measures, the CCC provided higher quality care than the gold standard of specialty care. A randomized controlled trial of the CCC model is warranted to determine its impact on patient‐centered outcomes and to assess whether the standard model of care should be altered.