Article Document Information Content Entity Continuant Continuant Entity Entity Review Generically Dependent Continuant 2025-05-07T17:23:15 RDF description of Integrated care in Parkinson's disease: a systematic review and meta-analysis [meta-analysis, review, systematic review] - http://repository.healthpartners.com/individual/document-rn23725 public 9 meta-analysis <p>BACKGROUND: Quality of life in Parkinson's disease (PD) is affected by motor and nonmotor symptoms, necessitating an integrated care approach. Existing care models vary considerably in numerous domains. The objectives of this study were to perform a systematic review and meta-analysis of PD integrated care models and develop recommendations for a representative model. METHODS: We conducted a systematic review of published integrated care models and a meta-analysis of randomized, controlled trials examining integrated care versus standard care. The primary outcome was health-related quality of life using a validated PD scale. We evaluated levels of care integration using the Rainbow Model of Integrated Care. RESULTS: Forty-eight publications were identified, including 8 randomized, controlled trials with health-related quality of life data (n = 1,149 total PD patients). Qualitative evaluation of individual care model integration guided by the Rainbow Model of Integrated Care revealed frequent clinical and professional integration, but infrequent organizational and population-based integration elements. Meta-analysis of randomized, controlled trials revealed significant heterogeneity (I(2) �=�90%, P <�0.0001). Subgroup analysis including only outpatient care models (n = 5) indicated homogeneity of effects (I(2) �=�0%, P =�0.52) and improved health-related quality of life favoring integrated care, with a small effect size (standardized mean difference [SMD], -0.17; 95% CI, -0.31 to -0.03; P =�0.02). CONCLUSIONS: Outpatient integrated PD care models may improve patient-reported health-related quality of life compared with standard care; however, because of variable methodological approaches and a high risk of bias related to inherent difficulties in study design (eg, blinding of participants and interventionists), generalizability of these results are difficult to establish. The Rainbow Model of Integrated Care is a promising method of evaluating elements and levels of integration from individual patient care to population health in a PD context. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, LLC. on behalf of International Parkinson and Movement Disorder Society.<p> review Delivery of Health Care Movement Disorders 2022-02-21T22:48:57.408-06:00 35 Models 10.1002/mds.28097 Integrated care in Parkinson's disease: a systematic review and meta-analysis [meta-analysis, review, systematic review] 30194 17917 systematic review Parkinson Disease document-rn23725 Quality of Life