THRIVE-PD: Transforming Health and Resilience through Interdisciplinary Virtual Engagement in Parkinson Disease
Roshini Srinivasan1, Sneha Mantri1, Kyle Mitchell1
1Duke University
Objective:

To examine the impact of a virtual comprehensive Parkinson disease (PD) care clinic on scores of patient self-efficacy and caregiver burden from baseline to 3 months post-visit.

Background:

Low self-efficacy and high caregiver burden are common in Parkinson disease (PD) and can impact quality of life for both partners. Time constraints in standard-care clinics limit exploration of these aspects of care, but interdisciplinary care clinics provide an avenue for integrated, 360° care, and telehealth may address the logistical challenges of coordinating multi-specialty care.

Design/Methods:

We developed a virtual interdisciplinary clinic for people with PD (PwP) and their care-partners (CPs) if present. Participants were randomized to the interdisciplinary clinic or standard of care, which consisted of a regular office visit with their movement disorders specialist. The primary outcomes were changes in the Self-Efficacy to Manage Chronic Disease Scale (SEMCD) and the Zarit Burden Interview (ZBI), which were completed prior to and 3 months after the clinic visit. Data were analyzed in a single-blind fashion by repeated measures ANOVA. An equity analysis compared virtual interdisciplinary care with historical access to in-person interdisciplinary care.

Results:

Fifty PwP and 24 CPs participated in benchmark or standard evaluations between January and September 2021; as of October 2021, 33 PwP and 10 CPs have completed all post-visit questionnaires and are included in this analysis. Among PwP, mean age (standard deviation, SD) was 69.1 (10.7) years; mean disease duration (SD) was 5.3 (6.0). There were statistically significant differences in mean SEMCD between standard and interdisciplinary PwP (F(1,31)=3.02, p=0.001) and in mean ZBI between standard and interdisciplinary CPs (F(1,8)=5.2, p=0.01). Virtual clinics increased access for rural residents but decreased access for Black participants (7.7% in-person vs 3.5% virtually; Z=-1.6, p=0.05).

Conclusions:

Virtual interdisciplinary clinics appear to be effective at improving patient self-efficacy and caregiver burden, but disparities in access require attention.