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Lithander FE, Tenison E, Ypinga J, Halteren A, Smith MD, Lloyd K, Richfield EW, Brazier DE, Breasail MÓ, Smink AJ, Metcalfe C, Hollingworth W, Bloem B, Munneke M, Ben-Shlomo Y, Darweesh SKL, Henderson EJ. Proactive and Integrated Management and Empowerment in Parkinson's Disease protocol for a randomised controlled trial (PRIME-UK) to evaluate a new model of care. Trials 2023; 24:147. [PMID: 36849987 PMCID: PMC9969590 DOI: 10.1186/s13063-023-07084-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/20/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND People living with Parkinson's disease experience progressive motor and non-motor symptoms, which negatively impact on health-related quality of life and can lead to an increased risk of hospitalisation. It is increasingly recognised that the current care models are not suitable for the needs of people with parkinsonism whose care needs evolve and change as the disease progresses. This trial aims to evaluate whether a complex and innovative model of integrated care will increase an individual's ability to achieve their personal goals, have a positive impact on health and symptom burden and be more cost-effective when compared with usual care. METHODS This is a single-centre, randomised controlled trial where people with parkinsonism and their informal caregivers are randomised into one of two groups: either PRIME Parkinson multi-component model of care or usual care. Adults ≥18 years with a diagnosis of parkinsonism, able to provide informed consent or the availability of a close friend or relative to act as a personal consultee if capacity to do so is absent and living in the trial geographical area are eligible. Up to three caregivers per patient can also take part, must be ≥18 years, provide informal, unpaid care and able to give informed consent. The primary outcome measure is goal attainment, as measured using the Bangor Goal Setting Interview. The duration of enrolment is 24 months. The total recruitment target is n=214, and the main analyses will be intention to treat. DISCUSSION This trial tests whether a novel model of care improves health and disease-related metrics including goal attainment and decreases hospitalisations whilst being more cost-effective than the current usual care. Subject to successful implementation of this intervention within one centre, the PRIME Parkinson model of care could then be evaluated within a cluster-randomised trial at multiple centres.
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Affiliation(s)
- Fiona E. Lithander
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK ,grid.9654.e0000 0004 0372 3343Liggins Institute, University of Auckland, Auckland, 1142 New Zealand ,grid.9654.e0000 0004 0372 3343Department of Nutrition and Dietetics, University of Auckland, Auckland, 1142 New Zealand
| | - Emma Tenison
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Jan Ypinga
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Angelika Halteren
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Matthew D. Smith
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Katherine Lloyd
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Edward W. Richfield
- grid.416201.00000 0004 0417 1173North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB UK
| | - Danielle E. Brazier
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Mícheál Ó. Breasail
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Agnes J. Smink
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Chris Metcalfe
- grid.5337.20000 0004 1936 7603Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, BS8 2PS UK
| | - William Hollingworth
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK ,grid.5337.20000 0004 1936 7603Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, BS8 2PS UK
| | - Bas Bloem
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Marten Munneke
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Yoav Ben-Shlomo
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK
| | - Sirwan K. L. Darweesh
- grid.10417.330000 0004 0444 9382Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Emily J. Henderson
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU UK ,grid.413029.d0000 0004 0374 2907Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, BA1 3NG UK
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