Objective: To review the disease profile of patients who were enrolled in the Home Care Program and evaluate the outcomes of the program.

Background: With the aim of bridging support between hospital and community in Parkinson’s disease (PD) management, the Home Care Program was established in April 2012. A dedicated nurse from the PD and Movement Disorders Centre paid regular home visits to at-risk patients with parkinsonism. The provision of the service included detecting potential complications, providing relevant advices, coordinating hospital and community services.

Methods: An audit on home visit records from the period of 1 April 2012 to 30 Sep 2014 was carried out. Statistical Package for Social Science (SPSS) version 22.0 was employed to analyse the data.

Results: Total number of 196 patients was enrolled into this program. There had been 139 patients being actively followed up. Of these, 74 were male and 65 were female. Their mean age was 74.32 years old (±8.58) and average duration of disease was 8.8 years (± 5.9). 112 (81%) were Parkinson patients while the rest were patients with atypical parkinsonism. Table 1 below revealed PD patient’s disease specific characteristics. The parameters were compared pre and post Home Care Program intervention by using Wilcoxon Signed-Rank test.

Table 1. Patient characteristics comparison pre and post Home Care Program

PD related parameters	Pre program (median)	Post program (median)	Z*	p*
UPDRS motor score	45.5	55	-1.933	0.053
Hoehn and Yahr Stage	4	5	-4.108	0.000
PDQ8	47.44	100	-5.179	0.000
Hospital Admission (times)	0.5	1	-0.198	0.843

Z* and p* derived from Wilcoxon Signed-Rank test; UPDRS motor score=Unified Parkinson’s disease Rating Scale motor score; PDQ 8=Parkinson’s disease Questionnaires 8 During the program, feedback from patients and their caregivers in this program were obtained. Total numbers of 58 written feedbacks were received. Of these, 51 (87%) patients felt that the frequency of home visit is just right. 52 out of 58 said that issues identified during home visit are followed up promptly. 51 patients (88%) had better understanding on issues related to Parkinson’s disease. 87% of them felt that they had better access to medical attention and community services. Almost all patients (95%) reckoned that the patient’s condition is monitored more closely. Overall, the Home Care Program was found to be helpful. Most patients (88%) hoped that this program would continue.

Conclusions: As a result of the program, our patients had a stable hospital admission rate despite deteriorations in disease severity and quality of life. The Home Care Program complemented hospital services to provide holistic care for PD patients. It was well accepted and appreciated by PD patients and their caregivers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/home-care-program-for-patients-with-parkinsons-disease-a-singapore-experience/