Integrated Care in Parkinson's Disease: A Systematic Review and Meta‐Analysis

Background Quality of life in Parkinson's disease (PD) is affected by motor and nonmotor symptoms, necessitating an integrated care approach. Existing care models vary considerably in numerous domains. The objectives of this study were to perform a systematic review and meta‐analysis of PD integrated care models and develop recommendations for a representative model. Methods We conducted a systematic review of published integrated care models and a meta‐analysis of randomized, controlled trials examining integrated care versus standard care. The primary outcome was health‐related quality of life using a validated PD scale. We evaluated levels of care integration using the Rainbow Model of Integrated Care. Results Forty‐eight publications were identified, including 8 randomized, controlled trials with health‐related quality of life data (n = 1,149 total PD patients). Qualitative evaluation of individual care model integration guided by the Rainbow Model of Integrated Care revealed frequent clinical and professional integration, but infrequent organizational and population‐based integration elements. Meta‐analysis of randomized, controlled trials revealed significant heterogeneity (I2 = 90%, P