Longitudinal, Interdisciplinary Home Visits Versus Usual Care for Homebound People With Advanced Parkinson Disease: Protocol for a Controlled Trial Article Swipe
Jori Fleisher
,
Serena Hess
,
Brianna Sennott
,
Erica Myrick
,
Ellen C. Klostermann
,
Jeanette Lee
,
Maya Sanghvi
,
Katheryn Woo
,
Bichun Ouyang
,
Jayne Wilkinson
,
James C. Beck
,
Tricia J. Johnson
,
Deborah A. Hall
,
Joshua Chodosh
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.2196/31690
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.2196/31690
Background The current understanding of advanced Parkinson disease (PD) and its treatment is largely based on data from outpatient visits. The most advanced and disabled individuals with PD are disconnected from both care and research. A previous pilot study among older, multimorbid patients with advanced PD demonstrated the feasibility of interdisciplinary home visits to reach the target population, improve care quality, and potentially avoid institutionalization. Objective The aim of this study protocol is to investigate whether interdisciplinary home visits can prevent a decline in quality of life of patients with PD and prevent worsening of caregiver strain. The protocol also explores whether program costs are offset by savings in health care utilization and institutionalization compared with usual care. Methods In this single-center, controlled trial, 65 patient-caregiver dyads affected by advanced PD (Hoehn and Yahr stages 3-5 and homebound) are recruited to receive quarterly interdisciplinary home visits over 1 year. The 1-year intervention is delivered by a nurse and a research coordinator, who travel to the home, and it is supported by a movement disorder specialist and social worker (both present by video). Each dyad is compared with age-, sex-, and Hoehn and Yahr stage–matched control dyads drawn from US participants in the longitudinal Parkinson’s Outcome Project registry. The primary outcome measure is the change in patient quality of life between baseline and 1 year. Secondary outcome measures include changes in Hoehn and Yahr stage, caregiver strain, self-reported fall frequency, emergency room visits, hospital admissions, and time to institutionalization or death. Intervention costs and changes in health care utilization will be analyzed in a budget impact analysis to explore the potential for model adaptation and dissemination. Results The protocol was funded in September 2017 and approved by the Rush Institutional Review Board in October 2017. Recruitment began in May 2018 and closed in November 2019 with 65 patient-caregiver dyads enrolled. All study visits have been completed, and analysis is underway. Conclusions To our knowledge, this is the first controlled trial to investigate the effects of interdisciplinary home visits among homebound individuals with advanced PD and their caregivers. This study also establishes a unique cohort of patients from whom we can study the natural course of advanced PD, its treatments, and unmet needs. Trial Registration ClinicalTrials.gov NCT03189459; http://clinicaltrials.gov/ct2/show/NCT03189459. International Registered Report Identifier (IRRID) PRR1-10.2196/31690
Related Topics
Concepts
Medicine
Institutionalisation
Quality of life (healthcare)
Caregiver burden
Randomized controlled trial
Population
Intervention (counseling)
Gerontology
Emergency department
Parkinson's disease
Physical therapy
Disease
Family medicine
Nursing
Psychiatry
Dementia
Pathology
Surgery
Environmental health
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2196/31690
- https://jmir.org/api/download?alt_name=resprot_v10i9e31690_app1.pdf&filename=b0f9598a3ff4091771ae36bdd0767ed5.pdf
- OA Status
- gold
- Cited By
- 11
- References
- 79
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3182017094
All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W3182017094Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.2196/31690Digital Object Identifier
- Title
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Longitudinal, Interdisciplinary Home Visits Versus Usual Care for Homebound People With Advanced Parkinson Disease: Protocol for a Controlled TrialWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-07-06Full publication date if available
- Authors
-
Jori Fleisher, Serena Hess, Brianna Sennott, Erica Myrick, Ellen C. Klostermann, Jeanette Lee, Maya Sanghvi, Katheryn Woo, Bichun Ouyang, Jayne Wilkinson, James C. Beck, Tricia J. Johnson, Deborah A. Hall, Joshua ChodoshList of authors in order
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https://doi.org/10.2196/31690Publisher landing page
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https://jmir.org/api/download?alt_name=resprot_v10i9e31690_app1.pdf&filename=b0f9598a3ff4091771ae36bdd0767ed5.pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://jmir.org/api/download?alt_name=resprot_v10i9e31690_app1.pdf&filename=b0f9598a3ff4091771ae36bdd0767ed5.pdfDirect OA link when available
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Medicine, Institutionalisation, Quality of life (healthcare), Caregiver burden, Randomized controlled trial, Population, Intervention (counseling), Gerontology, Emergency department, Parkinson's disease, Physical therapy, Disease, Family medicine, Nursing, Psychiatry, Dementia, Pathology, Surgery, Environmental healthTop concepts (fields/topics) attached by OpenAlex
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11Total citation count in OpenAlex
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2025: 2, 2024: 2, 2023: 2, 2022: 4, 2021: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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