Transforming Care Across Countries: Lessons from the Integrated Care Networks for Parkinson's Disease Study (iCARE-PD)

Abstract

Background: The optimal design for care delivery in Parkinson's disease (PD) that addresses changing needs of the lived experience is unclear. There is a critical need for care models to be implemented and transferable across diverse healthcare systems with agility. Objectives: We aimed to evaluate the multinational implementation and impact of a novel pragmatic integrated care delivery program for PD (iCARE-PD). Methods: We conducted a multinational prospective observational study with a pre-post design (six national PD tertiary centers) of a 4-month integrated care program focused on individualized care plans, enhanced system navigation, and self-care support. Primary outcomes: enrollment and program completion rates. Secondary outcomes: transnational feasibility of program implementation, processes outcomes, acceptability, and preliminary estimates of health-related outcomes changes. Results: Between May 2021 and February 2023, we enrolled 202 participants (“Newly Diagnosed,” n = 43; “Intermediate,” n = 54; “Complex Care Needs,” n = 105). Median site enrollment rate was 69.6% (range: 21.1–100), and the program completion rate was 96.5%. Overall, there was a positive change in Patient Assessment of Chronic Illness Care + (PACIC+ total score: 0.48; 95% confidence interval [CI]: 0.34, 0.61; P < 0.0001). We found a positive score change in the MDS-UPDRS Part II + III nontremor (4.03; 95% CI: 6.55, 1.52; P = 0.0018) in the “Complex Care Needs” group. Conclusions: The iCARE-PD model was successfully implemented across a social, cultural, and healthcare system diversity, with high program completion rates and improved care quality perceived by participants living at distinct stages of PD. The findings provide valuable insights about the transferability potential and impact of a pragmatic integrated care model centered in the community, with applicability to other chronic movement disorders. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.