scholarly journals Longitudinal, Interdisciplinary Home Visits vs. Usual Care for Homebound People with Advanced Parkinson’s Disease (IN-HOME-PD): Study protocol for a controlled trial (Preprint)

10.2196/31690 ◽  
2021 ◽  
Author(s):  
Jori Fleisher ◽  
Serena Hess ◽  
Brianna Sennott ◽  
Erica Myrick ◽  
Ellen Klostermann Wallace ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Usual Care ◽  
Study Protocol ◽  
Controlled Trial ◽  
Home Visits ◽  
Advanced Parkinson’S Disease

Longitudinal, Interdisciplinary Home Visits vs. Usual Care for Homebound People with Advanced Parkinson’s Disease (IN-HOME-PD): Study protocol for a controlled trial (Preprint)

2021 ◽  
Author(s):  
Jori Fleisher ◽  
Serena Hess ◽  
Brianna Sennott ◽  
Erica Myrick ◽  
Ellen Klostermann Wallace ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Controlled Trial ◽  
Home Visits ◽  
Caregiver Strain ◽  
Yahr Stage ◽  
Advanced Parkinson’S Disease ◽  
One Year

BACKGROUND Current understanding of advanced Parkinson’s disease (PD) and its treatment is largely based on data from outpatient visits. The most advanced and disabled individuals become disconnected from both care and research. A previous pilot study among older, multimorbid patients with advanced PD demonstrated the feasibility of interdisciplinary home visits to reach the target population, improve care quality, and potentially avoid institutionalization. OBJECTIVE The following protocol tests whether interdisciplinary home visits can 1) prevent decline in quality of life and 2) prevent worsening caregiver strain. Finally, the protocol explores whether program costs are offset by savings in healthcare use and institutionalization when compared with usual care. METHODS In this single-center, controlled trial, 65 patient-caregiver dyads affected by advanced PD (Hoehn & Yahr stages 3-5 and homebound) are recruited to receive quarterly interdisciplinary home visits over one year. The one-year intervention is delivered by a nurse and research coordinator who travel to the home supported by a movement disorders specialist and social worker (both present by video). Each dyad is compared with age-, sex-, and Hoehn and Yahr stage-matched control dyads drawn from US participants in the longitudinal Parkinson’s Outcome Project registry. The primary outcome measure is change in patient quality of life between baseline and one year. Secondary outcome measures include change in Hoehn & Yahr stage, caregiver strain, self-reported fall frequency, emergency room visits, hospital admissions, and time-to-institutionalization and/or death. Intervention costs and changes in healthcare utilization will be analyzed in a budget impact analysis exploring the potential for model adaptation and dissemination. RESULTS The protocol was funded in September 2017 and approved by the Rush Institutional Review Board in October 2017. Recruitment began in May 2018 and closed in November 2019 with 65 patient-caregiver dyads enrolled. All study visits have been completed and analysis is underway. CONCLUSIONS To our knowledge, this is the first controlled trial to investigate the effects of interdisciplinary home visits among homebound individuals with advanced Parkinson’s disease and their caregivers. This study also establishes a unique cohort of patients from whom we can study the natural course of advanced PD, its treatments, and unmet needs. CLINICALTRIAL Clinicaltrials.gov, NCT03189459.

scholarly journals Naftazone in advanced Parkinson's disease: An acute L-DOPA challenge randomized controlled trial

2019 ◽  
Vol 60 ◽  
pp. 51-56 ◽  
Author(s):  
Jean-Christophe Corvol ◽  
Franck Durif ◽  
Wassilios G. Meissner ◽  
Jean-Philippe Azulay ◽  
Raphaël Haddad ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Advanced Parkinson’S Disease ◽  
Randomized Controlled
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