Abstract

Methods This descriptive study used a survey to explore health-care experiences. Questionnaires were mailed to participants living in rural Victoria. Eligibility criteria included having a diagnosis of PD or Parkinsonism and sufficient English to respond to the survey. The validated Patient-Centred Questionnaire for PD was used to measure health-care experiences. The questions are grouped accordingly under one of the 6 subscales or domains. Outcomes from the questionnaire included summary experience scores (SES) for 6 subscales; overall patient-centeredness score (OPS); and quality improvement scores (QIS). Secondary outcomes included health-related quality of life using the disease-specific questionnaire PDQ39; disease severity using the Hoehn and Yahr staging tool; and disability using the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, part II. Results Thirty-nine surveys were returned from the East Gippsland group and 68 from the rural group. The East Gippsland group rated significantly more positive the subscales “empathy and PD expertise,” P=0.02, and “continuity and collaboration of professionals,” P=0.01. The groups did not differ significantly for the remaining 4 subscales (P > 0.05) nor for the OPS (P=0.17). The QIS showed both groups prioritised the health-care aspect “provision of tailored information” for improvement. Quality of life was greater (P < 0.05) and impairment (P=0.012) and disability were less (P=0.002) in the East Gippsland group. Conclusion Participants who received health care from the East Gippsland program had better key health-care experiences along with better QOL and less impairment and disability. Participants prioritised provision of information as needing further improvement.

Highlights

  • Parkinson’s disease (PD) is almost a lifelong progressive illness without cure

  • Recruitment for the East Gippsland group commenced in December 2016 and finished in February 2017 and that for the rural group commenced in May 2017 and was completed in December 2017

  • Conclusion e East Gippsland-modified Comprehensive Parkinson Care (CPC) model appears to have resulted in better patient-reported outcome measures (PROMs). e healthrelated quality of life (HRQOL) index score revealed a difference of four times the meaningful clinical significance, suggesting a robust difference between the groups

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Summary

Introduction

Parkinson’s disease (PD) is almost a lifelong progressive illness without cure. It manifests a profound complexity and a cumulative morbidity over the person’s lifetime and its elderly age group presentation adds to the burdens of agerelated comorbidities. At the request of local PD support organisations to improve access to specialist PD services in East Gippsland, a clinical liaison was established in 2012 between the Comprehensive Parkinson Care (CPC) program, Melbourne, and two service providers in East Gippsland Victoria (Bairnsdale Regional Health Service (BRHS) and Gippsland Lake Community Health). Is current study used the Dutch version of the PCQ-PD, available in English, as it included questions about each health-care member involved in our multidisciplinary team. As in the Dutch version, 46 care aspects were allocated to the following six subscales: involvement in decision-making; provision of tailored information; accessibility of healthcare; empathy and PD expertise; continuity and collaboration of professionals; and emotional support. Based on a previous study that used the PCQ-PD, the aim was to recruit 50 participants per group [15]

Results
Primary Outcome
Ethical Approval
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