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@ARTICLE{Eggers:850854,
      author       = {Eggers, Carsten and Dano, Richard and Schill, Juliane and
                      Fink, Gereon R. and Timmermann, Lars and Voltz, Raymond and
                      Golla, Heidrun and Lorenzl, Stefan},
      title        = {{A}ccess to {E}nd-of {L}ife {P}arkinson's {D}isease
                      {P}atients {T}hrough {P}atient-{C}entered {I}ntegrated
                      {H}ealthcare},
      journal      = {Frontiers in neurology},
      volume       = {9},
      issn         = {1664-2295},
      address      = {Lausanne},
      publisher    = {Frontiers Research Foundation},
      reportid     = {FZJ-2018-04614},
      pages        = {627},
      year         = {2018},
      abstract     = {Background: Palliative care in Parkinson's Disease (PD)
                      patients considerably differs from palliative care in
                      oncology patients. Integrated care models are a concept to
                      support patients and improve management of PD symptoms.
                      However, it is not known if the access to PD patients at the
                      end of life can be achieved through integrated care
                      models.Aim: To analyze an integrated model of care for PD
                      patients with the aim to identify if this integrated model
                      of care has access to PD patients at the end of
                      life.Material and Methods: The Cologne Parkinson's network
                      was designed as a randomized, controlled prospective
                      clinical trial in order to increase quality of life of PD
                      patients. This innovative model of care integrated a
                      neurologist in private practice, a movement disorder
                      specialist of the University Hospital and a PD nurse.
                      Mortality rates of PD patients during the study period of 6
                      months were registered and compared with mortality rates of
                      the general population of Germany according to the Federal
                      Statistical Office of Germany. The retrospective post-hoc
                      analysis was conducted after completion of the initial study
                      at the University Hospital and neurologists' practices in
                      the greater area of Cologne, Germany. Eligible patients had
                      a diagnosis of idiopathic PD and were aged 25–85
                      years.Results: Parkinson's Disease patients in this trial
                      had an even slightly lower mortality rate as the general
                      population (1.66 v. $2.1\%).$ These results are
                      contradictory and speak for a substantial proportion of
                      late-stage disease patients, who have not been adequately
                      included in this study or have been better treated within
                      this trial. The mean disease duration of patients in this
                      study was around 6 years which resembles the lower range of
                      the mean disease duration at death of PD patients in
                      generalConclusions: The results of our post-hoc analysis
                      show, that accessing PD patients in the last phase of their
                      disease is extremely difficult and nearly fails in spite of
                      an integrated care approach. Reasons for poor access and
                      loss of follow-up at the end of life have to be identified
                      and care models for PD patients until the end of life should
                      be developed urgently.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000440198900001},
      pubmed       = {pmid:30105000},
      doi          = {10.3389/fneur.2018.00627},
      url          = {https://juser.fz-juelich.de/record/850854},
}