Bridging the gap: Evaluating a community-based palliative care intervention for underserved patients with Parkinson's disease.

BACKGROUND

Parkinson's disease (PD) is a progressive neurodegenerative illness with a profound impact on quality of life (QOL). While palliative care has demonstrated benefits in PD, reach and evidence of effectiveness in underserved populations remain limited. The goal of this study was to evaluate the effect of a novel palliative care intervention on QOL among underserved patients with PD.

METHODS

We conducted a secondary analysis of data from a stepped-wedge, pragmatic clinical trial (NCT03076671) among 322 participants with PD. We created an "underserved demographic" composite variable based on rural residency, low income (<$50,000/year), and race/ethnicity (non-White or Hispanic). QOL was measured using the Quality of Life in Alzheimer's Disease Scale (QOL-AD) at baseline, 6 months, and 12 months. We used t-tests for group comparisons at baseline and linear mixed-effects models for longitudinal analyses.

RESULTS

A total of 129 participants were identified as underserved. The intervention showed significant improvement in QOL over time for non-underserved participants at 6 months (p = 0.06) and 12 months (p = 0.04). While overall improvements among underserved participants were not observed at earlier time points, we found a statistically significant time and group interaction effect suggesting a meaningful QOL improvement in the underserved group at 12 months compared to baseline (estimate = 2.39, 95% CI: 0.33-4.46, p = 0.05).

CONCLUSIONS

Findings suggest that this community-based palliative care intervention may help support improvements in QOL over time among underserved patients with PD. Tailored, longitudinal palliative care approaches may help bridge disparities in neurologic care.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03076671.