A Comprehensive Approach to Care in Parkinson's Disease Adds Quality to the Current Gold Standard. Issue 5 (15th June 2017)

• Record Type: Journal Article
• Authors: Vaughan, Camille P.; Prizer, Lindsay P.; Vandenberg, Ann E.; Goldstein, Felicia C.; Trotti, Lynn Marie; Hermida, Adriana P.; Factor, Stewart A.
• Is Part Of: Movement disorders clinical practice. Volume 4:Issue 5(2017)
• Page Start: 743
• Page End: 749
• Publication Date: 2017-06-15
• Subjects: multidisciplinary care -- nonmotor -- Parkinson's disease -- quality of care; Movement Disorders; Movement disorders -- Periodicals; Movement disorders; Periodicals; Periodicals; 616
• DOI: 10.1002/mdc3.12508
• Languages: English
• ISSNs: 2330-1619

Abstract

Abstract: 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.