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The aim of this project is to evaluate the needs and provision of care for patients with late stage Parkinsonism and their carers in several European countries, compare the effectiveness of different health and social care systems, and to lay the foundation for improved outcomes in this population. We will undertake a multimodal assessment of patients and their care arrangements in a population recruited through networks in six European countries, and evaluate effective management strategies through systematic literature review, cross-sectional and longitudinal assessments, and an open label trial of specialist review with management suggestions, guidance and access to telephone advice. Through interviews, questionnaire assessment and review of current health-care and social care arrangement, we will assess the needs, provision of care and use of health-care resources, and their impact on patient and carer outcomes in different countries. National and regional databases will also be interrogated to identify current practice and use of health-care resources and drug usage. A systematic literature review of the evidence for effective management strategies, analysis of the baseline and longitudinal data, and evaluation of change in outcomes following specialist review will provide the basis for recommendations in the management of late stage Parkinsonism. We will also evaluate potentially useful outcome measures for use in this patient group. In addition to charting the needs and current care provision for late stage Parkinsonism in different European countries, its cost and effectiveness, and an analysis of health-care and social care predictors of improved outcome, the project will produce a platform for the assessment of patients with late stage Parkinsonism, their current treatment and care provision, as well as guidelines on the management of this late disease phase.

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