People living with Parkinson's disease (PwP) experience a wide range of motor and non-motor symptoms associated with increasing complexity of care delivery. A multispecialty approach has been presented as an intuitive solution for tailored and comprehensive care delivery. Nevertheless, past trials of both multidisciplinary or interdisciplinary care models in PD suggested no measurable change to a small benefit in quality of life (QoL) and failed to show economic sustainability. We propose a home-based community-centred integrated care (iCARE-PD) for PwP as a pragmatic solution to harness the potential of existing care resources using an integrated care strategy, enable self-management support and implement technology-enabled care. The iCARE-PD model is based on Freeman's concept of continuity of care and the expanded Chronic Care Model for organization of care strategies. A home-based community-centred integrated care has immediate implications for clinical practice, with potential benefits in rural areas or lower-income countries, by enhancing access to care with optimized costs. There is a need to establish which and how interventions may be used as an instrument of care in each local deployment of the iCARE-PD model. We put forward a multidisciplinary framework to generate the evidence supportive of its implementation as the standard of care in the future and delineate the core strategies to secure the implementation of this care approach across different health care systems to ensure feasibility and economic sustainability. We envision this model becoming a paradigm of personalized care transferable to people with atypical forms of neurodegenerative parkinsonism.

Department of Neurology and Centre of Clinical Neuroscience 1st Faculty of Medicine and General University Hospital Charles University Prague Czech Republic

Department of Neurology University Hospital of Marburg Marburg Germany

Department of Neurosciences Padova University Padova Italy

Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland

HM CINAC Hospital Universitario HM Puerta Del Sur Universidad CEU San Pablo Madrid Spain

Instituto de Medicina Molecular Facultade de Medicina University of Lisbon Lisbon Portugal; Laboratory of Clinical Pharmacology and Therapeutics Facultade de Medicina Universidade de Lisboa Lisbon Portugal; CNS Campus Neurológico Sénior Torres Vedras Portugal

Instituto de Medicina Molecular Facultade de Medicina University of Lisbon Lisbon Portugal; Laboratory of Clinical Pharmacology and Therapeutics Facultade de Medicina Universidade de Lisboa Lisbon Portugal; Department of Neurosciences Clinical Investigation Center CIC 1436 Parkinson Toulouse Expert Center NS Park FCRIN Network and NeuroToul COEN Center TOULOUSE University Hospital INSERM University of Toulouse 3 Toulouse France

Laboratory of Clinical Pharmacology and Therapeutics Facultade de Medicina Universidade de Lisboa Lisbon Portugal; CNS Campus Neurológico Sénior Torres Vedras Portugal

Parkinson's Disease and Movement Disorders Center Division of Neurology Department of Medicine The Ottawa Hospital Research Institute University of Ottawa Ottawa Canada

Services de Neurologie et de Pharmacologie Clinique Centre de Reference AMS Centre D'Investigation Clinique Réseau NS Park FCRIN et Centre of Excellence for Neurodegenerative Disorders de Toulouse CHU de Toulouse Toulouse 3 University Toulouse France

Serviço de Anestesiologia Centro Hospitalar Universitário Lisboa Norte Lisbon Portugal

Citace poskytuje Crossref.org

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