Objective: This study aims to systematically review the evidence investigating the efficacy of multidisciplinary Parkinson’s disease (PD) care on physical and quality of life outcomes in people with PD.

Background: PD is the second most common neurodegenerative condition in Singapore, resulting in disabling and distressing motor and non-motor symptoms. Although multidisciplinary care have been advocated in recent years, little is known of its efficacy in the long-term management of these patients.

Methods: A targeted search to identify full-text English-language randomized controlled trials (RCTs) published till June 2016 was conducted across 5 electronic databases (Cochrane, PsycInfo, Scopus, Embase, CINAHL). Methodological quality was assessed using the Cochrane “Risk of bias” tool and relevant data was extracted using a standardized form by 2 independent reviewers and compared for accuracy. Mean or standardized mean differences (SMD) were calculated for meta-analyses using fixed or random effects model depending on study heterogeneity.

Results: Six studies (of 1616 screened titles and abstracts), comprising of 637 participants with early to advanced disease (Hoehn and Yahr stage 1 to 4), were included. The meta-analyses demonstrated significant SMD in favour of multidisciplinary care versus non-multidisciplinary controls for quality of life (-0.96; 95% CI, -1.74 to -0.19; p=0.01), disease severity quantified by the Unified PD Rating Scale motor section (MD=-26.03; 95% CI, -47.92 to -4.14, p = 0.02) but not for depression (-0.29; 95% CI, -0.73, 0.16, p=0.21) and caregiver strain (MD=-1.28; 95% CI,-2.56 to 0.00, p=0.05).

Conclusions: This review demonstrated that multidisciplinary care can result in significant improvement in quality of life and PD motor symptoms in people with early to advanced PD, but does not have a significant effect on depression and caregiver strain. The small sample sizes and presence of biases in existing studies highlight the need for further high quality research in this area.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-of-multidisciplinary-care-in-people-with-parkinsons-disease-a-systematic-review-and-meta-analysis/