Abstract
Background: Palliative care in Parkinson's Disease (PD) patients considerably differs from palliative care in oncology patients. Integrated care models are a concept to support patients and improve management of PD symptoms. However, it is not known if the access to PD patients at the end of life can be achieved through integrated care models.Aim: To analyze an integrated model of care for PD patients with the aim to identify if this integrated model of care has access to PD patients at the end of life.Material and Methods: The Cologne Parkinson's network was designed as a randomized, controlled prospective clinical trial in order to increase quality of life of PD patients. This innovative model of care integrated a neurologist in private practice, a movement disorder specialist of the University Hospital and a PD nurse. Mortality rates of PD patients during the study period of 6 months were registered and compared with mortality rates of the general population of Germany according to the Federal Statistical Office of Germany. The retrospective post-hoc analysis was conducted after completion of the initial study at the University Hospital and neurologists' practices in the greater area of Cologne, Germany. Eligible patients had a diagnosis of idiopathic PD and were aged 25–85 years.Results: Parkinson's Disease patients in this trial had an even slightly lower mortality rate as the general population (1.66 v. 2.1%). These results are contradictory and speak for a substantial proportion of late-stage disease patients, who have not been adequately included in this study or have been better treated within this trial. The mean disease duration of patients in this study was around 6 years which resembles the lower range of the mean disease duration at death of PD patients in general.Conclusions: The results of our post-hoc analysis show, that accessing PD patients in the last phase of their disease is extremely difficult and nearly fails in spite of an integrated care approach. Reasons for poor access and loss of follow-up at the end of life have to be identified and care models for PD patients until the end of life should be developed urgently.
Highlights
Despite a significant progress in treatment strategies and modern therapy concepts neurodegenerative diseases like idiopathic Parkinson’s disease (PD) or atypical Parkinsonian disorders inevitably lead to progressive motor, neuropsychiatric and nonmotor symptoms [1,2,3,4,5]
Palliative care in PD patients considerably differs from palliative care provision in oncology patients, in terms of the models of care, the provision and the duration
Patients were screened for potential involvement [age 25–85 years, exclusion criteria were unstable medical condition as a co-morbidity, major depression (BDI-2 >30 points), severe cognitive decline (PANDA
Summary
Despite a significant progress in treatment strategies and modern therapy concepts neurodegenerative diseases like idiopathic Parkinson’s disease (PD) or atypical Parkinsonian disorders inevitably lead to progressive motor, neuropsychiatric and nonmotor symptoms [1,2,3,4,5]. The mean duration until death ranges between 6.9 and 14.3 years, where increasing age and development of dementia were most commonly associated with increased mortality [9]. Palliative care in PD patients considerably differs from palliative care provision in oncology patients, in terms of the models of care, the provision and the duration. Palliative care in Parkinson’s Disease (PD) patients considerably differs from palliative care in oncology patients. Integrated care models are a concept to support patients and improve management of PD symptoms. It is not known if the access to PD patients at the end of life can be achieved through integrated care models
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
