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

摘要: Abstract Objective: To determine the effects of community based nurses specialising in Parkinson9s disease on health outcomes and healthcare costs. Design: Two year randomised controlled trial. Setting: 438 general practices nine randomly selected authority areas England. Participants: 1859 patients with identified by participating practices. Main outcome measures: Survival, stand-up test, dot square bone fracture, global question, PDQ-39, Euroqol, Results: After two years 315 (17.3%) had died, although mortality did not differ between those who were attended nurse specialists receiving standard care from their practitioner (hazard ratio for group v control 0.91, 95% confidence interval 0.73 to 1.13). No significant differences found groups test (odds 1.15, 0.93 1.42) score (difference 0.7, 3.25 1.84). Scores question significantly better than controls 0.23, 0.4 0.06), but no difference was observed results PDQ-39 or Euroqol questionnaires. Direct costs patient increased an average £2658 during study, differentially groups: increase £266 lower among a specialist (£981 £449). Conclusions: Nurse little effect clinical condition patients, they improve patients9 sense wellbeing, What is already known this topic Most have regular contact consultants Contact attending hospital increases provision information subjectively valued It has been shown whether psychosocial functioning study adds Provision does slow progression Nurses help preserve wellbeing Healthcare are