Objective: We sought to systematically examine the effectiveness of case management interventions on common preventable complications associated with Parkinson’s Disease, both in people with Parkinson’s Disease as well as in people with other chronic health conditions. We specifically focused on falls, depression, anxiety, hallucinations, urinary tract infections and swallowing impairments.

Background: There is a lack of systematic insight on the effect of case management on common complications associated with Parkinson’s Disease, which is an important gap in knowledge given their unmet needs on care coordination. Furthermore, it remains unclear whether putative beneficial effects of case management on common complications would vary by key patient characteristics, such as their age, gender or disease characteristics. Such insight would contribute to a broader shift from “one size fits all”- based healthcare resource allocation to personalized medicine.

Method: From PubMed and Embase searches with predefined inclusion criteria, we identified studies published up till February 2020. For each study, relevant data were extracted independently by two researchers. A mixed methods approach was applied using narrative and random effects meta-analysis methods.

Results: 22 randomized controlled trials and three non-randomized reported on the effect of case management on feelings of anxiety (8 studies) or symptoms of depression (24 studies). No single study reported on the effect of case management on falls, hallucinations, urinary tract infections or swallowing impairments. Across meta-analyses, we observed a statistically significant effect of case management on reducing feelings of anxiety (SMD = – 0.56; CI: -0.76, -0.36) and symptoms of depression (SMD = – 0.53; CI: -0.79, -0.26). We found a large heterogeneity between studies reporting on depressive symptoms which were not explained by patient population characteristics that were available across studies.

Conclusion: This systematic review found evidence for the beneficial effect of case management with regard to decrease in symptoms of depression and feelings of anxiety. Future studies should focus on the optimal content, frequency and intensity of case management interventions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-case-management-interventions-in-reducing-common-preventable-complications-associated-with-parkinsons-disease-a-systematic-review-and-meta-analysis/