A Randomized Study of the Efficacy of the PROPATH Program for Patients With Parkinson Disease

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Abstract
Objectives: To assess (1) the effects of the PROPATH Program, a health management program designed for patients with Parkinson disease, on perceived general health and psychological well-being and satisfaction with medical care, (2) utilization of health care resources by patients with Parkinson disease, and (3) physician impressions of the PROPATH Program. Design: Patients were randomized to receive either the PROPATH Program in addition to usual care or usual medical care only. All patients and their physicians completed periodic questionnaires designed to assess the study variables. Setting: Staff model health maintenance organization from June 1992 through June 1993. Patients: Forty-six English-speaking patients diagnosed with Parkinson disease of Hoehn-Yahr stages I through IV. Results: Enrollment in the PROPATH Program resulted in a statistically significant improvement in patient perception of general health and psychological well-being after 1 year. There was no significant difference in patient satisfaction with medical care or utilization of health care resources. The large majority of physicians did not find the PROPATH Program to be helpful for development of a treatment plan, management of the illness, identification of problems sooner than by usual treatment, or identification of drug side effects. Conclusions: The PROPATH Program may play a useful role in assisting patients to deal with the psychological aspect of Parkinson disease by improving perception of general health and psychological well-being. The program had no significant effect on patient satisfaction with medical care or medical resource utilization.

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