A meta-analysis of the effect of multidisciplinary comprehensive care on health-related quality of life and Unified Parkinson's Disease Rating Scale in Parkinson's disease.

Abstract

According to many reports, multidisciplinary comprehensive care alleviates Parkinson's disease (PD) more frequently than any other standard care, though the results were found to vary greatly. A systematic literature search up to July 2022 was performed and 1234 related studies were evaluated. The chosen studies comprised 1115 subjects with PD who participated in baseline trials; 633 of them were under multidisciplinary comprehensive care, while 482 were under standard care. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (95% CIs) were calculated to measure the results of multidisciplinary comprehensive care for PD by the contentious and dichotomous approaches with a random or fixed influence model employed. The use of multidisciplinary comprehensive care resulted in significantly better health-related quality of life (HRQL) (MD: -3.17; 95% CI: -5.98--0.35, p = 0.03) and Unified Parkinson's Disease Rating Scale (UPDRS) score (MD: -5.25; 95% CI: -10.14--0.37, p = 0.04) compared to the standard care for subjects with PD. Nevertheless, no significant difference was found between multidisciplinary comprehensive care and standard care for subjects with PD regarding medication dosage (MD: 0.31; 95% CI: -0.72-1.34, p = 0.56) and caregiver strain (MD: -0.51; 95% CI: -1.69-0.67, p = 0.40). Outpatient multidisciplinary comprehensive care models may improve patient-reported HRQL and UPDRS score; nevertheless, no significant difference was found in terms of medication dosage and caregiver strain compared to the standard care for subjects with PD. The small sample size of 2 out of 7 analyzed studies and the small number of studies in certain comparisons requires attention when analyzing the results.