Zhongguo quanke yixue (Dec 2024)
Effect of Parkinson's Disease Management Model Dominated by Movement Disorder Specialists and Centered on Community Doctors
Abstract
Background The incidence of Parkinson's disease (PD) is increasing year by year, which has increased the disease burden of medical insurance, and the current chronic disease management model has not played a role in the community management of PD patients. Objective To explore the effect of PD management model led by a movement disorders specialist and centered on community doctors, in order to improve the comprehensive management ability of community doctors for PD patients and improve the quality of life of PD patients. Methods One hundred and two PD patients who were treated at the Neurology Department of the Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology from January 2022 to May 2023 were selected as the research subjects and were divided into the control group and the active intervention group by random digit table method, with 51 cases in each group. The control group received conventional community management, while the active intervention group received proactive management by community doctors specializing in PD. The management content included drug adjustment, exercise rehabilitation, dietary nutrition, cognitive function and psychological function management. Evaluations were conducted for the patients within one week of their return to the community (before intervention) and six months later (after intervention). The evaluation included a single day equivalent dose of levodopa, UPDRS-Ⅲ, UPDRS-Ⅳ, Hoehn-Yahr (H-Y) staging, and 39-item Parkinson's Disease Quality of Life Questionnaire (PDQ-39) . Results At 6 months, the levodopa equivalent dose in the active intervention group was higher than before management, and the UPDRS-Ⅲ score, other complication dimensions of UPDRS-Ⅳ, and PDQ-39 score were lower than before (P<0.05). The Spearman rank correlation analysis results showed that the difference in PDQ-39 scores between the active intervention group and the control group before and after management was positively correlated with their scores in mental health, humiliation, cognition, social support, communication, and physical discomfort (rs values ranged from 0.651 to 0.893, P<0.05), positively correlated with the score of other complication dimensions of UPDRS-Ⅳ (rs=0.338, P<0.05), but not correlated with the UPDRS-Ⅲ score (P>0.05). The results of the univariate Logistic regression analysis showed that the probability of PDQ-39 reduction in the active intervention group was 11.769 times that of the control group (95%CI=4.340-31.918, P<0.001) . Conclusion The PD management model led by movement disorder specialists and centered on community doctors can improve the quality of life of patients, which provides a reference for PD community management.
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