The PRIME-NL study: evaluating a complex healthcare intervention for people with Parkinson's disease in a dynamic environment.

Autor: Maas BR; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands., van den Bergh R; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands., van den Berg SW; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands., Hulstein E; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands., Stadhouders N; IQ Health, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands., Jeurissen PPT; IQ Health, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands., de Vries NM; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands., Bloem BR; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands., Munneke M; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands., Ben-Shlomo Y; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Darweesh SKL; Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud university medical center, Nijmegen, The Netherlands. Sirwan.Darweesh@radboudumc.nl.
Jazyk: angličtina
Zdroj: BMC neurology [BMC Neurol] 2024 Aug 03; Vol. 24 (1), pp. 269. Date of Electronic Publication: 2024 Aug 03.
DOI: 10.1186/s12883-024-03778-x
Abstrakt: Background: An innovative, integrative care model for people with Parkinson (PRIME Parkinson) has gradually been implemented in a selected region of the Netherlands since 2021. A prospective evaluation of this model (PRIME-NL study) was initiated in parallel, spanning the year prior to implementation (baseline) and the implementation period. Following publication of the original study protocol, the COVID-19 crisis delayed implementation of the full PRIME Parkinson care model by two years and hampered the recruitment of study participants.
Objective: To describe which methodological adjustments were made to the study protocol because of these developments.
Methods: We compare various outcomes between a region where PRIME Parkinson care was implemented (innovation region) versus the rest of the Netherlands (usual care region). We use healthcare claims data of virtually all people with Parkinson in the Netherlands and annual questionnaires in a representative subsample of 984 people with Parkinson, 566 caregivers and 192 healthcare professionals. Four major methodological adjustments had to be made since publication of the original protocol. First, we extended the evaluation period by two years. Second, we incorporated annual process measures of the stage of implementation of the new care model. Third, we introduced a real-time iterative feedback loop of interim results to relevant stakeholders. Fourth, we updated the statistical analysis plan.
Discussion: This manuscript provides transparency in how the design and analyses of the evaluation study had to be adapted to control for external influences in a dynamic environment, including eruption of the COVID-19 crisis. Our solutions could serve as a template for evaluating other complex healthcare interventions in a dynamic environment.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje