Integrating Palliative Care in Parkinson's Disease and Related Disorders: A Systematic Review of Patient and Caregiver Outcomes.

BackgroundPeople living with Parkinson's disease (PD) and related parkinsonian disorders (PDRD) experience multidimensional needs that may benefit from palliative care (PC).ObjectivesTo systematically review the impact of PC integration for people with PD/PDRD and their caregivers.MethodsMEDLINE, Web of Science, Scopus, and Cochrane were searched for English-language articles to December 31, 2024. Eligible studies enrolled adults with PD/PDRD receiving any PC intervention vs usual neurological care. Studies enrolling mixed long-term neurological cohorts (including PD/PDRD) were included and treated as indirect evidence relevant to PD/PDRD. Outcomes included symptom management/burden (SMB), quality of life (QOL), satisfaction with care (patient/caregiver), and caregiver burden (CB). Risk of bias was assessed, and results were synthesized narratively. This review was registered in PROSPERO.ResultsSeven studies (n = 1621) were included (4 randomized trials; 4 from the United States of America). All studies assessing SMB reported improvements in intervention groups, though not across every symptom. Four of 6 studies reported significant QOL gains; 2 found no difference. Satisfaction findings were mixed (1 improvement, 1 no change). Three of 5 studies reported reductions in CB, particularly beyond 12 months. The qualitative study highlighted dissatisfaction with standard care and perceived benefits of PC in communication, interdisciplinary support, and linkage to community resources. Findings from mixed cohorts were consistent in direction but interpreted cautiously due to indirectness.ConclusionsIntegrating PC for PD/PDRD shows promise for improving symptoms, QOL, and caregiver outcomes. Clearer PD/PDRD-specific trials-using consistent terminology and reporting-are needed to strengthen inference.