Objective: To evaluate whether PRIME-Parkinson care increases the ability of people with parkinsonism (PwP) to achieve their personal goals, has a positive impact on health and symptom burden, and is cost-effective when compared with usual care.

Background: There are multiple challenges facing the care of PwP, including a growing global burden and inadequacies in current care. Care is uniform, reactive, uncoordinated, and struggles to meet the complex and changing needs of PwP. In response to this, a novel model of care, PRIME-Parkinson care, has been developed. Although seemingly addressing the current issues, it is unclear whether it can improve outcomes for PwP in a cost-effective manner.

Method: This is a single-centre randomised controlled trial (RCT) conducted at the Royal United Hospital Bath NHS Trust, UK. Adults with parkinsonism were randomised (1:1) to receive PRIME-Parkinson care in addition to usual care, or usual care alone for a 24-month period. PRIME-Parkinson care is a multicomponent, complex intervention delivered flexibly according to participant need. The primary outcome measure is personal goal attainment using the Bangor Goal Setting Interview. Secondary outcomes encompass measures across multiple domains of health and wellbeing. Analysis is by intention to treat using a multi-level model to examine change in personal goal attainment over the intervention period.

Results: Between October 2022 and July 2023, 214 PwP were recruited (107 usual care, 107 active arm). The median age was 75 years (IQR 70-80) and 35% (n=75) were female. The most common diagnosis was idiopathic PD (n=184, 86%) with a median disease duration of 8 years (IQR 6-10). Participants were spread across all Hoehn & Yahr stages (1-2 [n=100 46.7%], 3-4 [n=97 45.3%], 5 [n=17 7.9%]). The median total MDS-UPDRS score was 68 (IQR 50-98). Using SHARE-FI75+, 42 participants (20.1%) were frail, 97 (46.4%) pre-frail and 70 (33.5%) non-frail. Most participants set 3 goals (n=176, 82.2%). On a Likert scale of 1-10, the median goal attainment at baseline was 5.3 (IQR 2.7-9.3). To date, the retainment in the trial is 89%.

Conclusion: PRIME-Parkinson care has been operationalised as a multicomponent intervention and its effectiveness tested in a RCT. The trial has recruited to target and is in the final stages of follow-up. The results will be presented for the first time at the Congress with discussion around the implications for clinical care, future research, and health policy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/results-from-the-prime-uk-randomised-controlled-trial/