TY - JOUR
T1 - Patterns and predictors of referrals to allied health services for individuals with Parkinson's disease
T2 - A Parkinson's foundation (PF) QII study
AU - Parkinson's Foundation Quality Improvement Initiative Investigators Steering Committee Members
AU - PF QII Principal Investigators
AU - Roberts, Angela C.
AU - Rafferty, Miriam R.
AU - Wu, Samuel S.
AU - Miao, Guanhuong
AU - Cubillos, Fernando
AU - Simuni, Tanya
AU - Marras, Connie
AU - Davis, Tom
AU - Dahodwala, Nabila
AU - Neault, Marilyn
AU - Ramirez-Zamora, Adolfo
AU - Rafferty, Miriam
AU - Malaty, Irene
AU - Parashos, Sotirios
AU - Kraakevik, Jeff
AU - Jankovic, Joseph
AU - Simon, David
AU - Pahwa, Rajesh
AU - Mills, Kelly
AU - Way, Christopher
AU - Morgan, John
AU - Pagan, Fernando
AU - Hauser, Robert
AU - Davis, Thomas
AU - Salins, Naomi
AU - Gurevich, Tanya
AU - Bloem, Bastiaan
AU - Singer, Carlos
AU - Lafontaine, Anne Louise
AU - Feigin, Andrew
AU - Miyasaki, Janis
AU - Litvan, Irene
N1 - Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2021/2
Y1 - 2021/2
N2 - Introduction: Rehabilitation therapies are critical for optimizing quality-of-life and daily functions for individuals living with Parkinson's disease (PD). Thus, understanding the patterns of and under what conditions physicians make rehabilitation referrals is important for optimizing care. Method: We analyzed data from 5020 participants (4 countries) collected from 1/3/2016 to 4/20/2018 as part of the Parkinson's Foundation Quality Improvement Initiative (PF QII). Data were analyzed for single discipline and multidiscipline referrals to speech language pathology (SLP), physical therapy (PT), and occupational therapy (OT). Group comparisons (referred vs. not-referred) and regression procedures were implemented to determine demographic and clinical variables that were associated with an increased likelihood of rehabilitation referral. Results: 35.3% of participants were referred to rehabilitation services. Of these, 25.1% received a multidiscipline referral. There was a statistically significant effect of disease stage on both single discipline (χ2(2) = 45.1, p < 0.0001) and multidiscipline (χ2(2) = 74.2, p < 0.0001) referrals, with higher rates in later stages. Referred vs. not-referred participants differed significantly on a number of variables; however, only falls in the 6-months prior, advanced- and moderate-stage disease, older age, hospital admissions, and higher caregiver burden were associated with an increased likelihood of rehabilitation referral (adjusted odds ratios ≥ 1, Range = 1.08 to 1.62). Conclusions: Despite evidence supporting multidiscipline and proactive rehabilitation in PD, the majority of referrals were made to a single service and may be reactions to falls or advancing disease. Data suggest there may be missed opportunities for optimizing care through proactive rehabilitation interventions.
AB - Introduction: Rehabilitation therapies are critical for optimizing quality-of-life and daily functions for individuals living with Parkinson's disease (PD). Thus, understanding the patterns of and under what conditions physicians make rehabilitation referrals is important for optimizing care. Method: We analyzed data from 5020 participants (4 countries) collected from 1/3/2016 to 4/20/2018 as part of the Parkinson's Foundation Quality Improvement Initiative (PF QII). Data were analyzed for single discipline and multidiscipline referrals to speech language pathology (SLP), physical therapy (PT), and occupational therapy (OT). Group comparisons (referred vs. not-referred) and regression procedures were implemented to determine demographic and clinical variables that were associated with an increased likelihood of rehabilitation referral. Results: 35.3% of participants were referred to rehabilitation services. Of these, 25.1% received a multidiscipline referral. There was a statistically significant effect of disease stage on both single discipline (χ2(2) = 45.1, p < 0.0001) and multidiscipline (χ2(2) = 74.2, p < 0.0001) referrals, with higher rates in later stages. Referred vs. not-referred participants differed significantly on a number of variables; however, only falls in the 6-months prior, advanced- and moderate-stage disease, older age, hospital admissions, and higher caregiver burden were associated with an increased likelihood of rehabilitation referral (adjusted odds ratios ≥ 1, Range = 1.08 to 1.62). Conclusions: Despite evidence supporting multidiscipline and proactive rehabilitation in PD, the majority of referrals were made to a single service and may be reactions to falls or advancing disease. Data suggest there may be missed opportunities for optimizing care through proactive rehabilitation interventions.
KW - Allied health
KW - Expert care centers
KW - OT
KW - Occupational therapy
KW - PT
KW - Parkinson's disease
KW - Physical therapy
KW - Physiotherapy
KW - Referrals
KW - Rehabilitation
KW - SLP
KW - Speech language pathology
KW - Speech therapy
KW - Utilization
UR - http://www.scopus.com/inward/record.url?scp=85097739343&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2020.11.024
DO - 10.1016/j.parkreldis.2020.11.024
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C2 - 33339716
AN - SCOPUS:85097739343
SN - 1353-8020
VL - 83
SP - 115
EP - 122
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
ER -