Contact with a Nurse Practitioner: A Short-Term Evaluation Study in Parkinson’s Disease and Dystonia

Abstract

Forty patients with Parkinson's disease and 24 patients with dystonia took part in a study aiming to assess the value of access to and contact with a nurse practitioner over a 6 month period. Patients in each group were randomly allocated to “intervention” or “control” groups, which were matched on important variables. All patients completed a set of questionnaires relating to psychosocial function at two time points separated by 6 months. In the intervening period, those allocated to the “intervention” group received two home visits and five telephone calls from the nurse practitioner. This contact was not provided to the “control” group. The nurse practitioner had a major impact on the provision of information and the facilitation of referral to other health-care agencies. The results of an independent assessment indicated that the patients in the “intervention” programme had found access to and contact with a nurse practitioner of great value. In contrast, the results of the questionnaire assessment did not reveal any statistically significant change in psychosocial functioning from the first to the second assessment for either the “intervention” or “control” groups. The lack of change in the questionnaire measures is discussed in terms of possible sampling bias and the duration of intervention and follow-up. Recommendations are made for future studies, and for the possible provision of clinical services.

Effects of community based nurses specialising in Parkinson's disease on health outcome and costs: randomised controlled trial

“…However, our findings mostly agree with those of an earlier hospital based study, which found that patients with Parkinson's disease subjectively valued nurse specialists although their psychosocial functioning did not improve 12. Our study also mostly agrees with the recent hospital based randomised trial of 185 patients with Parkinson's disease, which found no evidence of a nurse specialist effect on a range of self reported health outcomes 27…”

“…These nurse specialists were initially promoted by consultants with an interest in Parkinson's disease in response to the need for coordination of their patients' education, monitoring, and care (box 1), but their effectiveness has not been evaluated comprehensively. 10 11 A small controlled study based in a tertiary hospital clinic for Parkinson's disease evaluated the effect of two community based nurse specialists undertaking two home visits to patients with Parkinson's disease and having five telephone contacts over a six month period 12. The nurses had a positive impact on provision of information and were subjectively valued but had no detectable benefit on patients' psychosocial functioning.…”

What matters to people with Parkinson’s disease living in Australia?

“…A randomised controlled trial (RCT) of 1859 patients conducted in the UK found that community-based PD nurse specialist care significantly improved mean self-reported global health scores over 2 years compared to people who received standard GP care, although health-related quality of life or functioning and wellbeing measures were not significantly different [24]. Another RCT of 40 patients in the UK found no significant differences between baseline and 6 month follow-up scores on psychosocial outcomes in both the group that received frequent contact with a nurse practitioner and the group that received standard GP care [25]. Whilst there is limited evidence in the published literature showing strong objective benefits of nurse specialist interventions in PD, by taking a patient-centred approach to PD care, our findings add to data showing that PD nurse specialists are desirable to people living with PD in the community.…”

The Cost-Effectiveness of specialized Nursing Interventions for people with Parkinson’s Disease: the NICE-PD study protocol for a randomized controlled clinical trial

“…So far, only three studies have evaluated PDNS care, with inconsistent results. Overall, the findings suggested that PDNS care may improve patient wellbeing, physical functioning and general health status and reduce anxiety and depression [12,13,14], but definite conclusions cannot be drawn.…”