Evaluation of Proactive and Integrated Management and Empowerment in Parkinson’s Disease (PRIME Parkinson) in The Netherlands a prospective observational study

Objective:
We will evaluate the utility of PRIME Parkinson care on a single primary endpoint (parkinsonism-related complications), which reflects the Population Health dimension, and on several secondary endpoints. The reference will be usual care in other regions in the Netherlands.

Background:
There is growing recognition that current care does not optimally meet the needs of patients with parkinsonism, including patients with Parkinson’s Disease [1,2]. Consequently, the quality of care is perceived as suboptimal by patients, carers and healthcare professionals. To address the limitations, an integrated care model that focuses on regional collaboration is proposed (table 1) [3]. We recently developed an integrated care model: Proactive and Integrated Management and Empowerment in Parkinson’s Disease (PRIME Parkinson). This model will replace usual care for patients with parkinsonism in the PRIME Parkinson care region in the Netherlands from 2020 onwards (figure 1) [4].

Method:
This is a prospective observational study comprising two data sources: healthcare claims-based data and questionnaire-based data. Baseline assessments will take place before implementation of the new care model in the PRIME Parkinson care region. The study will continue until 2023. We will use healthcare claims-based data to evaluate the primary endpoint in 2000 patients with parkinsonism receiving PRIME Parkinson care and 2000 matched patients receiving usual care (figure 2). We will also use healthcare claims-based data to evaluate Cost of Healthcare. We will evaluate secondary endpoints of Population Health as well as the Patient Experience, Carer Experience and Healthcare Professional Experience dimensions by performing annual questionnaire-based assessments. These assessments will be administered to a subsample of 600 patients, 300 carers and 150 healthcare professionals in the PRIME Parkinson care region and 600 patients and 300 carers in usual care regions.

Results:
Results are expected stepwise until 2024.

Conclusion:
This study will determine the utility of an integrated care approach for patients with parkinsonism that emphasizes proactive management and empowerment of patients and professionals. Potentially positive results may be applicable to patients with parkinsonism in other regions and may encourage adoption of a similar model for other chronic health conditions.