Universität zu Köln

Eggers, Carsten, Dano, Richard, Schill, Juliane, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Timmermann, Lars ORCID: 0000-0002-5301-3580, Voltz, Raymond ORCID: 0000-0002-4761-3395, Golla, Heidrun ORCID: 0000-0002-4403-630X and Lorenzl, Stefan ORCID: 0000-0002-1165-0821 (2018). Access to End-of Life Parkinson's Disease Patients Through Patient-Centered Integrated Healthcare. Front. Neurol., 9. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-2295

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Abstract

Background: Palliative care in Parkinson's Disease (PD) patients considerably differs from palliative care in oncology patients Integrated care models are a concept to support patients and improve management of PD symptoms. However, it is not known if the access to PD patients at the end of life can be achieved through integrated care models. Aim: To analyze an integrated model of care for PD patients with the aim to identify if this integrated model of care has access to PD patients at the end of life. Material and Methods: The Cologne Parkinson's network was designed as a randomized, controlled prospective clinical trial in order to increase quality of life of PD patients. This innovative model of care integrated a neurologist in private practice, a movement disorder specialist of the University Hospital and a PD nurse. Mortality rates of PD patients during the study period of 6 months were registered and compared with mortality rates of the general population of Germany according to the Federal Statistical Office of Germany. The retrospective post-hoc analysis was conducted after completion of the initial study at the University Hospital and neurologists' practices in the greater area of Cologne, Germany Eligible patients had a diagnosis of idiopathic PD and were aged 25-85 years. Results: Parkinson's Disease patients in this trial had an even slightly lower mortality rate as the general population (1.66 v. 2.1 %). These results are contradictory and speak for a substantial proportion of late-stage disease patients, who have not been adequately included in this study or have been better treated within this trial. The mean disease duration of patients in this study was around 6 years which resembles the lower range of the mean disease duration at death of PD patients in general. Conclusions: The results of our post-hoc analysis show, that accessing PD patients in the last phase of their disease is extremely difficult and nearly fails in spite of an integrated care approach. Reasons for poor access and loss of follow-up at the end of life have to be identified and care models for PD patients until the end of life should be developed urgently.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eggers, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Dano, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Schill, Juliane UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Timmermann, Lars UNSPECIFIED orcid.org/0000-0002-5301-3580 UNSPECIFIED Voltz, Raymond UNSPECIFIED orcid.org/0000-0002-4761-3395 UNSPECIFIED Golla, Heidrun UNSPECIFIED orcid.org/0000-0002-4403-630X UNSPECIFIED Lorenzl, Stefan UNSPECIFIED orcid.org/0000-0002-1165-0821 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-179364
DOI:	10.3389/fneur.2018.00627
Journal or Publication Title:	Front. Neurol.
Volume:	9
Date:	2018
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-2295
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Sonstiges > Zentrum für Versorgungsforschung Köln
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language PALLIATIVE CARE; EXPERIENCES; QUALITY; PEOPLE Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17936