Integrated Multidisciplinary Care for Parkinson's Disease: a Controlled Trial
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Purpose
The aim of the present study is to evaluate the (cost) effectiveness of a new health care system in which an individualised multidisciplinary assessment is given to patients with Parkinson's Disease(PD)in combination with treatment by a dedicated team of specifically trained health professionals, compared to usual care. Overall, we anticipate to gain more insight in the clinical effectiveness and health care costs of multidisciplinary treatment in PD.
| Condition | Intervention | Phase |
|---|---|---|
|
Parkinson's Disease |
Other: Multidisciplinary Care Other: Usual Care |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Supportive Care |
| Official Title: | Integrated Multidisciplinary Care for Parkinson's Disease: a Controlled Trial |
- Parkinson's Disease Quality of Life Questionnaire (PDQL) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- AMC Linear Disability Score (ALDS) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- SF-36 (secundary;utility score) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- UPDRS Motor Examination (part III)(secondary) [ Time Frame: 4 months ] [ Designated as safety issue: No ]
- UPDRS Complications of therapy (part IV)(tertiary) [ Time Frame: 4 months ] [ Designated as safety issue: No ]
- SPDDS(tertiary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- Modified MACTAR scale(tertiary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- Parkinson Activity Scale(tertiary) [ Time Frame: 4 months ] [ Designated as safety issue: No ]
- Costs (secondary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- Frequency of falls (tertiary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- Freezing of Gait Questionnaire (tertiary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- Falls Efficacy Scale (tertiary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- Non-Motor Symptom Assessment Scale and Quest for Parkinson's Disease (tertiary) [ Time Frame: 8 months (Quest) and 4 months (Scale) ] [ Designated as safety issue: No ]
- Hospital Anxiety and Depression Scale (tertiary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
- Caregiver burden assessed with BELA-A-k (secondary), SF-36 (tertiary), and HADS (tertiary) [ Time Frame: 8 months ] [ Designated as safety issue: No ]
| Enrollment: | 301 |
| Study Start Date: | August 2007 |
| Study Completion Date: | August 2010 |
| Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: I
Multidisciplinary Care
|
Other: Multidisciplinary Care
A comprehensive individualised assessment by a dedicated multidisciplinary team (Multidisciplinary Assessment Center) and subsequent treatment by specifically trained health professionals (ParkinsonNet).
Other Name: n.a.
|
|
II
Usual Care
|
Other: Usual Care
No altered organisation of care
Other Name: n.a.
|
Detailed Description:
PD is a complex disorder, with motor as well as non-motor symptoms. Despite the complexity of PD, management of the disease is often 'monodisciplinary' since most patients are only treated by a neurologist. Stimulating compensatory strategies by allied health professionals might offer additional therapeutic relief, but this assumption is mainly based on theoretical arguments and expert opinion. Even less is known about the claim that a multidisciplinary team of multiple professionals active in complementary domains (e.g. physiotherapy, occupational therapy and speech therapy) is superior to management by each of these professionals alone.
This study anticipates to provide more insight in the clinical effectiveness and health care costs of multidisciplinary treatment in PD. Therefore, our multidisciplinary care concept (a comprehensive assessment by a dedicated multidisciplinary team and subsequent treatment by specifically trained health professionals) that is tailored to the patients' individual needs will be compared to usual care in terms of effectiveness and costs.
Eligibility| Ages Eligible for Study: | 20 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with Idiopathic PD, diagnosed according to the Brain Bank Criteria of the UK Parkinson's Disease Society
- Regular control by the neurologist
- Living independently in the community
- Able to complete the trial questionnaires
Exclusion Criteria:
- Atypical parkinsonian syndromes
- Hoehn and Yahr stage 5
- Severe cognitive impairment (MMSE<24)
- Presence of other neurological disorders
- Severe co-morbidity (e.g. cancer)
- Planned surgical procedure for PD within the intervention period
- Patients who have already visited the Multidisciplinary Assessment Center
Contacts and Locations| Netherlands | |
| Ziekenhuis Groep Twente, Twenteborg Ziekenhuis | |
| Almelo, Netherlands | |
| Ziekenhuis Rijnstate | |
| Arnhem, Netherlands | |
| Wilhelmina Ziekenhuis Assen | |
| Assen, Netherlands | |
| Ziekenhuis Groep Twente, Streekziekenhuis Midden-Twente | |
| Hengelo, Netherlands | |
| Medisch Centrum Leeuwarden | |
| Leeuwarden, Netherlands | |
| Canisius Wilhelmina Ziekenhuis | |
| Nijmegen, Netherlands | |
| Principal Investigator: | Marten Munneke, PhD | UMC St Radboud |
| Principal Investigator: | Bastiaan R Bloem, MD, PhD | UMC St Radboud |
| Principal Investigator: | Marjolein A van der Marck, MSc | UMC St Radboud |
More Information
No publications provided
| Responsible Party: | Dr M Munneke, UMC St Radboud, Neurology |
| ClinicalTrials.gov Identifier: | NCT00518791 History of Changes |
| Other Study ID Numbers: | 2010-IP5.1 |
| Study First Received: | August 20, 2007 |
| Last Updated: | November 4, 2010 |
| Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
Keywords provided by Radboud University:
|
Integrated health care system Treatment effectiveness Cost effectiveness Program evaluation |
Additional relevant MeSH terms:
|
Parkinson Disease Parkinsonian Disorders Basal Ganglia Diseases Brain Diseases |
Central Nervous System Diseases Nervous System Diseases Movement Disorders Neurodegenerative Diseases |
ClinicalTrials.gov processed this record on May 22, 2013