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帕金森网络治疗(PaNTher)在帕金森病患者日常生活活动和健康相关生活质量中的实施及效果:一项在门诊护理中进行的混合方法观察性队列研究方案。

Implementation and the effects of a Parkinson Network Therapy (PaNTher) on activities of daily living and health-related quality of life in Parkinson's disease patients: study protocol of an mixed-method observational cohort study in outpatient care.

机构信息

Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Munich, Germany

Pettenkofer School of Public Health, Munich, Germany.

出版信息

BMJ Open. 2023 Nov 27;13(11):e075338. doi: 10.1136/bmjopen-2023-075338.

Abstract

INTRODUCTION

Parkinson's disease (PD) represents the fastest growing neurodegenerative disease with an increasing prevalence worldwide. It is characterised by complex motor and non-motor symptoms that lead to considerable disability. Specialised physiotherapy has been shown to benefit patients with PD. The (PaNTher) was created to improve access to specialised physiotherapy tailored to care priorities of PD patients. This study aims to evaluate the effectiveness, acceptability and needs of the PaNTher network by neurologists and physiotherapists involved in the network in outpatient care.

METHODS AND ANALYSIS

This is a mixed-method, prospective, pragmatic non-randomised cohort study of parallel groups, with data collection taking place in Bavaria, Germany, between 2020 and 2024. Patients with PD insured by the (AOK Bayern) living in Bavaria will be recruited for study participation by network partners. Patients in the intervention group must reside in Munich or the surrounding area to ensure provision of specialised physiotherapy in close proximity to their place of residence. Controls receive care as usual. Six and 12 months after baseline, all patients receive a follow-up questionnaire. Mixed-effect regression models will be used to examine changes in impairment of activities of daily living and quality of life of patients with PD enrolled in the programme over time compared with usual care. Qualitative interviews will investigate the implementation processes and acceptability of the PaNTher network among neurologists and physiotherapists. The study is expected to show that the PaNTher network with an integrative care approach will improve the quality and effectiveness of the management and treatment of patients with PD.

ETHICS AND DISSEMINATION

The study has been approved by the ethics committee at the medical faculty of the Ludwig-Maximilians-University Munich (20-318). Results will be published in scientific, peer-reviewed journals and presented at national and international conferences.

摘要

简介

帕金森病(PD)是增长最快的神经退行性疾病,全球患病率不断上升。它的特点是复杂的运动和非运动症状,导致相当大的残疾。已经证明,专门的物理疗法对 PD 患者有益。创建(PaNTher)是为了改善获得专门的物理疗法的机会,这些疗法针对 PD 患者的护理重点进行了调整。本研究旨在通过参与网络的神经科医生和物理治疗师评估 PaNTher 网络的有效性、可接受性和需求,这些医生和治疗师参与了门诊护理。

方法和分析

这是一项混合方法、前瞻性、实用的非随机队列研究,采用平行组设计,数据收集时间为 2020 年至 2024 年期间在德国巴伐利亚进行。通过网络合作伙伴招募 AOK Bayern 保险的 PD 患者参加研究。干预组的患者必须居住在慕尼黑或周边地区,以确保在他们居住的地方附近提供专门的物理治疗。对照组接受常规护理。在基线后 6 个月和 12 个月,所有患者都会收到一份随访问卷。混合效应回归模型将用于随时间检查参与该计划的 PD 患者日常生活活动能力和生活质量的改善情况,与常规护理相比。定性访谈将调查神经科医生和物理治疗师对 PaNTher 网络的实施过程和可接受性。该研究预计表明,具有综合护理方法的 PaNTher 网络将改善 PD 患者的管理和治疗质量和效果。

伦理和传播

该研究已获得慕尼黑路德维希-马克西米利安大学医学系伦理委员会的批准(20-318)。结果将发表在科学、同行评议的期刊上,并在国家和国际会议上展示。

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