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 ]

• Parkinson's Disease Quality of Life Questionnaire (PDQL) [ Time Frame: 8 months ]
• AMC Linear Disability Score (ALDS) [ Time Frame: 8 months ]

• 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 ]

• SF-36 [ Time Frame: 8 months ]
• UPDRS Motor Examination (part III) [ Time Frame: 4 months ]
• UPDRS Complications of therapy (part IV) [ Time Frame: 4 months ]
• SPDDS [ Time Frame: 8 months ]
• Modified MACTAR scale [ Time Frame: 8 months ]
• Parkinson Activity Scale [ Time Frame: 4 months ]
• Costs [ Time Frame: 8 months ]
• Frequency of falls [ Time Frame: 8 months ]
• Freezing of Gait Questionnaire [ Time Frame: 8 months ]
• Falls Efficacy Scale [ Time Frame: 8 months ]
• Non-Motor Symptom Assessment Scale for Parkinson's Disease [ Time Frame: 8 months ]
• Hospital Anxiety and Depression Scale [ Time Frame: 8 months ]
• Caregiver burden assessed with BELA-A-k, SF-36, and HADS [ Time Frame: 8 months ]

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.

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.

• 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.
• Other: Usual Care
  No altered organisation of care
  Other Name: n.a.

• Experimental: I
  Multidisciplinary Care
  Intervention: Other: Multidisciplinary Care
• II
  Usual Care
  Intervention: Other: Usual Care

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

• Stichting Nuts Ohra
• Porticus