Development of the Integrated Parkinson's Care Network (IPCN): using co-design to plan collaborative care for people with Parkinson's disease

Qual Life Res. 2019 May;28(5):1355-1364. doi: 10.1007/s11136-018-2092-0. Epub 2019 Jan 2.

Abstract

Background: Parkinson's disease (PD) is a progressive neurological illness that impacts various aspects of life. Integration of medical and self-management in a collaborative approach to care is needed to enhance functioning and the quality of life of PD patients. In developing an integrated care program at a tertiary PD clinic, we used a co-design process to gather stakeholder input.

Methods: This is a cross-sectional mixed methods study using surveys and interviews. Patient and caregiver participants from the clinic completed two questionnaires to evaluate perceived receipt of self-management support (Patient Assessment of Care for Chronic Conditions) and activation for managing their health condition (Patient or Caregiver Activation Measure®). A subset of these participants and healthcare providers took part in semi-structured interviews. Survey data were described and tested for relationships between patient characteristics and questionnaire scores using Spearman's rank-order correlation. Interviews were analyzed using conventional content analysis.

Results: Fifty-seven PD patients and thirty caregivers completed the questionnaires. Thirteen patients, six caregivers, and six healthcare providers were interviewed. 58% of participants were moderately to highly activated to manage their lives with PD. Participants' perceptions of self-management support varied but was lacking in dimensions of goal-setting and follow-up support/coordination. Qualitative analysis revealed four overarching themes related to experiences of managing PD: activation, self-management support, coordinated care, and access to services.

Conclusions: This first study to explore patient activation in PD found high levels of activation but moderate to low levels of self-management support. The co-design process highlighted important aspects of a more collaborative approach to care.

Keywords: Co-design; Collaborative care; Parkinson’s disease; Self-management.

Publication types

  • Observational Study

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged
  • Caregivers
  • Cross-Sectional Studies
  • Disease Management*
  • Female
  • Health Personnel
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / psychology*
  • Parkinson Disease / therapy
  • Quality of Life / psychology*
  • Self Care / psychology*
  • Surveys and Questionnaires