{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:06:41Z","timestamp":1791558401907,"version":"4.3.4"},"reference-count":76,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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\u2010analysis of PD integrated care models and develop recommendations for a representative model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review of published integrated care models and a meta\u2010analysis of randomized, controlled trials examining integrated care versus standard care. The primary outcome was health\u2010related quality of life using a validated PD scale. We evaluated levels of care integration using the Rainbow Model of Integrated Care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010eight publications were identified, including 8 randomized, controlled trials with health\u2010related 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\u2010based integration elements. Meta\u2010analysis of randomized, controlled trials revealed significant heterogeneity (I<jats:sup>2<\/jats:sup>\u2009=\u200990%, <jats:italic>P<\/jats:italic> &lt;\u20090.0001). Subgroup analysis including only outpatient care models (n = 5) indicated homogeneity of effects (I<jats:sup>2<\/jats:sup>\u2009=\u20090%, <jats:italic>P<\/jats:italic> =\u20090.52) and improved health\u2010related quality of life favoring integrated care, with a small effect size (standardized mean difference [SMD], \u22120.17; 95% CI, \u22120.31 to \u22120.03; <jats:italic>P<\/jats:italic> =\u20090.02)<jats:italic>.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Outpatient integrated PD care models may improve patient\u2010reported health\u2010related quality of life compared with standard care; however, because of variable methodological approaches and a high risk of bias related to inherent difficulties in study design (eg, blinding of participants and interventionists), generalizability of these results are difficult to establish. The Rainbow Model of Integrated Care is a promising method of evaluating elements and levels of integration from individual patient care to population health in a PD context. \u00a9 2020 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals, LLC. on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.28097","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T11:18:04Z","timestamp":1593429484000},"page":"1509-1531","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":134,"title":["Integrated Care in Parkinson's Disease: A Systematic Review and <scp>Meta\u2010Analysis<\/scp>"],"prefix":"10.1002","volume":"35","author":[{"given":"Roopa","family":"Rajan","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences  New Delhi 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University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Neurology Universityof P\u00e9cs  P\u00e9cs Hungary"},{"name":"MTA\u2010PTE Clinical Neuroscience MR Research Group  P\u00e9cs Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"McGinley","sequence":"additional","affiliation":[{"name":"Physiotherapy Department The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios A.","family":"Parashos","sequence":"additional","affiliation":[{"name":"Struthers Parkinson's Center, Park Nicollet Health Services  Golden Valley Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.P.","family":"Piemonte","sequence":"additional","affiliation":[{"name":"University of Sao Paulo, Medical School, Physical Therapy, Speech 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