Perceptions of Clinical Academics and People With Parkinson’s Disease on Delivery of Regional Interdisciplinary Model of Care: Qualitative Descriptive Study

Abstract

Introduction/Objective:

The objective of the study was to develop an understanding of the perceptions of people with Parkinson’s disease and clinical academics on the implementation of a regional interdisciplinary model of care.

Methods:

A qualitative descriptive study was undertaken. A PD interdisciplinary clinic was conducted in an Australian regional location. As a novel variation, in this clinic, 4 clinical academics consulted simultaneously offering a long, 3-h appointment. Following the clinic, we conducted 2 focus groups with all clinical academics and 6 semi-structured interviews with people with PD and carers. Data were analyzed using Elo & Kyngäs’ inductive content analysis approach.

Results:

An overarching main category namely, “interdisciplinary care proved valuable to regional people with PD and clinical academics,” and 3 generic-categories including “identifying interdisciplinary care as a viable option in regional locations,” “current care provision is disempowering and burdensome,” and “regional residing people with PD and their carers seek locally accessible healthcare with PD skilled clinicians” were identified.

Conclusion:

Our findings suggest the implementation of interdisciplinary care to regional healthcare systems is valued by clinical academics and people with PD and carers. Further research is required to establish how interdisciplinary care can be implemented in regional Australia and its effects on practice changes, patient outcomes, and quality of life.

Introduction/Background

Parkinson’s disease (PD) is the second most common chronic, progressive, and incurable neuropsychiatric disorder.^1,2 PD’s prevalence, disability, and mortality rates are growing faster than other neurodegenerative conditions. ³ This increasing prevalence has been linked to the growing global burden of disease. In 2016, there were 6.1 million people living with PD (PwP) globally.^3,4

PD results from a pathophysiologic loss or degeneration of dopaminergic neurons in the substantia nigra and the development of neuronal Lewy Bodies. Risk factors for the development of PD include ageing, family history, exposure to pesticide and environmental chemicals ⁵ and COVID-19 infection. ⁶ The major impact of disability confronting PwP, and their carers are associated with what is known as the condition’s 4 cardinal motor symptoms (MS). These include tremor, rigidity and stiffness, slowness and loss of movement, impaired balance, and coordination, and the constellation of debilitating and more burdensome non-motor symptoms (NMS). ⁷ Typically, the NMS are divided into 3 domains being neuropsychiatric, autonomic dysfunction and sleep disorders. ⁸ It is the combination of both MS and NMS which adversely affect the quality of life (QoL) of PwP and their carers^9,10 with the burden accumulating as the disease progresses and reaches its advanced stages. ¹¹

To date there is no cure for PD, but it is considered a treatable condition. For PwP, the aims of management are to support their ability to participate in meaningful activities and be self-managers.^12,13 To achieve this, there are 4 pillars of evidence-based management (1) prescribing conventional anti-Parkinson’s medications, (2) implementing interdisciplinary care, (3) engaging people with PD and their carers, and (4) applying device assisted therapies when appropriate. ¹² To address the disability experienced, holistic and person-centred interdisciplinary care is recommended. ²

In Australia, a definition of the interdisciplinary care approach was proposed by Jessup ¹⁴ who suggested it was the integration of separate healthcare disciplines into a single consultation where history taking, assessment, diagnosis, intervention and short- and long-term management goals are formulated by the healthcare team along with input from the patient. An interdisciplinary care approach is differentiated from a multidisciplinary one by healthcare disciplines working independently of each other to formulate discipline specific care plans.

Despite recommendations, the introduction of interdisciplinary care for PD in regional areas is challenging and compounded by disparities in population and healthcare infrastructure. ¹⁵ For example, in regional Australia, a greater proportion of aged people, with high levels of care requirements, is observed. ¹⁶ Furthermore, current research has identified that regional healthcare systems often suffer from insufficient expertise among different healthcare professionals, poor interdisciplinary collaboration, and communication.^17,18 Regional healthcare systems able to accommodate engagement of PwP and their carers may translate into improvements of both MS and NMS management, particularly for PwP in the advanced stages of the condition. ¹⁹ However, a paucity of research exists on how regional primary healthcare systems are designed to meet the needs of PwP and their carers.^20,21

Regional primary healthcare systems are responsible for the provision of healthcare to a geographically defined population. They must cater to the promotion of healthy ageing in its population. As PD is a condition with an increasing number and complexity of symptoms as the condition progresses, providing accessible healthcare locally is an imperative for regional healthcare systems.^18,22,23

Thus, a qualitative investigation was undertaken to develop an understanding of the perceptions of PwP and clinical academics on the implementation of a regional interdisciplinary model of care where interdisciplinary care for PD did not exist before. The investigation was funded by a university seed grant requiring it to be completed within 12 months of receiving the grant.

Methods

This study used a qualitative descriptive research methodology because the researchers were aiming to understand both the perceptions of PwP on receiving interdisciplinary care and insight into the clinical academics’ experiences as providers of interdisciplinary care for PD in a regional interdisciplinary clinic. This approach was required, as within regional Australia, implementing interdisciplinary models of care for PD is a poorly understood phenomenon.

For this paper, the authors have used the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist as a reporting guide.

Study Setting and Sample

A PD interdisciplinary clinic was conducted in a regional location to provide services locally. It was located within the previously established university clinical facilities located on its regional campus. In accordance with the previous definition of interdisciplinary care, ¹⁴ in this novel clinic, 4 clinical academics from nursing, physiotherapy, occupational therapy and pharmacy consulted simultaneously with a person with PD and their carer (if they attended) in a long appointment of 3 h duration (Supplemental Figure 1 Model of the Interdisciplinary PD clinic). The team did not include a general practitioner or movement disorder specialist or neurologist, as medicine is not a discipline offered for study by the clinical academics’ university and due to the lack of availability of medical personnel during the study’s time frame.

In the first 2 h of the consultation, the clinical academics simultaneously completed the patient history, measured vital signs, conducted physical examinations, psychosocial needs assessments, medication reconciliation, home safety, and health service utilization review and determined the person’s and carer’s goals. Over the next half an hour, in the absence of the person with PD and carer, the clinical academics discussed assessment findings, care planning, educational and counseling requirements, and developed an integrated care plan. Lastly, in the final half an hour, the care plan was delivered to the person with PD and their carer by the clinical academic nurse. Where follow-up was required, for example, referral to local clinicians or the person’s general practitioner to discuss PD medication management, this activity was also completed by the nurse. When consent had been provided by the PwP, follow-up clinic letters were distributed to the person’s general practitioner and/or treating neurologist.

This study involved 2 participant groups. Group 1 included clinical academics, 1 each from nursing (Nse), physiotherapy (PT), occupational therapy (OT), and pharmacy (Ph) (n = 4). Review of the literature could not isolate a standardized definition for clinical academics, ²⁴ but in this study, the term conceptualized by Kehoe et al ²⁵ was appropriate. The authors defined a clinical academic as an university academic who is professionally trained, registered, and actively practicing in their disciplines, whilst concurrently conducting research and/or teaching in their university posts. ²⁵ Two of the clinical academics held professional positions. The Nse was a senior academic who conducted a monthly nurse-led clinic for PD within the university healthcare facilities and the PT was an academic who facilitated regular student-led PD exercise classes. Of this participant group, the clinical academic nurse was the chief investigator. Special interest in PD management had facilitated previous collaborations and the clinical academics were purposively selected with inclusion criteria being that they possessed specialist PD knowledge. All clinical academics consented to participate and did so voluntarily.

For the second participant group, a convenience and purposive sample of PwP and their carers (n = 8 (n = 6 were PwP, n = 2 were carers)) were recruited from a regional PD support group known to the chief investigator. Inclusion criteria for group 2 included confirmed diagnosis of idiopathic PD, residing in a regional location, were able to attend the clinic appointment independently or with a carer, be English speaking, capable of participating in assessment(s), and be stable in their anti-Parkinson’s disease medication regime. Stability of the medication regime was defined as no change in their prescribed medications for 6 weeks prior to the clinic appointment. The carers were not required to have specialist training for caring for a person with PD. All potential participants were originally emailed participant information sheets and consent forms by the chief investigator. Participation was voluntary. Once informed consent was gained, and the PwP (or carer) completed a pre-clinic questionnaire which included information about their current disease stage, medication regime, and management of their PD. Submitted information was used by the clinical academics to guide their assessments. All participants completed the study. Demographic data of group 2 participants are available in Supplemental Table 1 Demographic data of PwP and carers.

Data Collection

Qualitative methods used were semi structured interviewing and focus groups with the guides approved by the university’s ethics committee. For participant group 1, clinical academics, data were collected via 2 face to face focus group interviews. Group 2, PwP and carers, data were collected via 6 semi-structured interviews using either telephone or ZOOM. The group 1 focus group interviews were undertaken by the chief and co-investigator, over 35 to 53 min. Group 2 semi-structured individual interviews were completed by either the chief or co-investigator and lasted from 26 to 44 min. Member checking of group 2 interview transcripts was hampered by the project’s time limitations. All interviews were audio-recorded and transcribed verbatim by the chief investigator and along with the co-investigator, transcripts were reviewed for accuracy.

Ethical approval was granted by the University’s Human Ethics and Research Committee (#204788). All participants were assigned a pseudonym to protect their identity and maintain confidentiality. This work was funded by a University Research Seed Grant Fund.

Data Analysis

Interview data were analyzed utilizing Elo and Kyngäs’ ²⁶ inductive content analysis. The chief and co-investigator, who are both experienced qualitative researchers utilized the checklist for researchers attempting to improve the trustworthiness of a content analysis study as recommended by Elo et al. ²⁷ Analysis of group 2 data was conducted manually, and for its manifest content only because most data were collected virtually (via telephone) with no visual access between investigators and participants. As such, some latent data could not be collected. Data analysis occurred in 3 main phases. Firstly, all data were read and reread by the investigators. During this preparatory phase, concepts were derived and classified into categories known as “units of analysis” ²⁶ (p. 109). Secondly, open coding was performed where the units of analysis led to the formulation of higher order category lists. Finally, during the abstraction process, categories were grouped together into sub-categories, which were subsequently grouped into generic categories before into final main categories.

Results

An overarching category namely, “interdisciplinary care proved valuable to regional people with PD and clinical academics,” and 3 generic-categories including “identifying interdisciplinary care as a viable option in regional locations,” “current care provision is disempowering and burdensome,” “regional residing people with PD and their carers seek locally accessible healthcare with PD skilled clinicians” were identified in this study (Supplemental Figure 2 Abstraction of collected data: main, generic, and sub-categories).

Interdisciplinary Care Proved Valuable to Regional People With PD and Clinical Academics

This major category (Supplemental Figure 2) showed that the clinical academics felt the introduction of the novel interdisciplinary clinic was a valuable way to address physical, social, mental health, and overall wellbeing of a person with PD in regional areas.

Clinical academics were mindful of the strength of their individual disciplines, but working together in an interdisciplinary way was perceived as a preferable model of care. This was exemplified by the clinical academic nurse, who functioned as the liaison and resource person for the clinical academic team, articulating that nursing was the “glue” of the team. Additionally, the clinical academic nurse was also actively undertaking assessment(s), providing input on management of MS and NMS, education, and assessment of the effectiveness of currently prescribed and other medications being used by PwP. The clinical academic physiotherapist described the application of a “person-centred approach for the management of motor and non-motor symptoms.” Whereas the clinical academic occupational therapist, suggested their contribution was for “adaption management strategies for the condition’s progression addressing a scope of problems that related to cognition, functional abilities, and energy conservation.” Lastly, the clinical academic pharmacist shared their focus related to “reducing the burden associated with complex medication regimens often required when living with PD” and described their contribution in the following way:

“It is helping to make taking the medicines more streamlined because it is quite burdensome for PD, and their [PwP] lives rotate around medications.” Ph

Together the clinical academics assessed MS and NMS in the PwP. They spoke of completing concurrent assessments making them feel as though “convergence” had resulted and spoke of this as being a valuable aspect of the regional interdisciplinary clinic. Additionally, this process served to dispel preconceived ideas they held about interdisciplinary care as being “hard work”:

“. . .people have said to me [ interdisciplinary clinics] are hard because everyone is trying to do each other’s jobs and it wasn’t, there was none of that. It was extraordinary.” OT

Furthermore, clinical academics in this study spoke of how no-one assumed a lead role in the interdisciplinary clinic, and this facilitated an improvement in their personal and professional PD management abilities:

“Disciplines converged. Assessments were useful even if asked by another clinical academic – assessment was not clumsy, we all built social capital.” Nse

And,

“It was fabulous, we learned very rapidly, and without any ‘this is how you do it,’ we all fit in.” OT

Thus, they shared views about how interdisciplinary “convergence” may be possible in regional environments, when introducing a new model of care for regional areas lacking skilled PD clinicians.

In the regional interdisciplinary clinic, the story of the person with PD’s journey was heard by all clinical academics at the same time where immediate opportunities were taken to clarify any misunderstandings in the assessment. Later, all clinical academics met for a half hour session to craft an integrated person-centred care plan. Undertaking concurrent assessment and care planning was spoken of as critical aspect for promoting PwP’s dignity and overall wellbeing:

“. . .helping maintain the dignity of being able to continue to look after themselves. I think it is critical to continue to have good mental health outcomes, and they need as much support as we can give them.” OT

Adopting a team approach facilitated the placing of PwP at the centre of care. Collaborating and utilizing the expertise of all clinical academics was a way they felt PwP were enabled to become more capable self-managers.

“. . .they [person with PD] could go home feeling more confident and more hopeful.” OT

The impact that the interdisciplinary clinic had on appointment burden for PwP was an initial concern. Specifically, the concerns related to a 3-h appointment being tiring, overwhelming, or onerous. Instead, the clinical academics perceived that one long, consolidated consultation was less burdensome than a multitude of appointments with various clinicians attended on the same or different days:

“It [the clinic appointment] didn’t exhaust the clients. It was a good use of their time.” Ph

Insight was gained by clinical academics into the impact of the emotion work required by PwP during appointments from having to repeat their story:

“One of the constant comments I get is that [previously] they keep having to repeat their stories. It makes them tired and frustrated.” OT

PwP and carers also appeared to approve of one long appointment:

“I think the idea of a team was excellent because you can go and spend time with them [clinical academics] in one place. You’ve got these people that are skilled, you can ask the question and you can be advised and you’re not going from one place to another.” Carer 2

Thus, insight and understanding were gained from both participant groups on how regional interdisciplinary care can improve quality of life in PwP by promoting self-management, reducing appointment burden, and optimizing their use of time.

Identifying Interdisciplinary Care as a Viable Option in Regional Locations

Clinical academics in this study gained understanding on how the novel interdisciplinary model clinic implemented dispelled their preconceived ideas about interdisciplinary care. They identified that support and investment from regional healthcare services are required to act on the hesitation of implementing interdisciplinary models of care and to negate the dominant biomedical models, thereby promoting evidence-based PD management.

For the carers of people with PD, instead of feeling threatened by meeting all clinical academics simultaneously, they suggested that they felt safe and empowered:

“I thought it was done extremely well, I didn’t feel threatened at any time or intimidated or as though anybody was pushing for more information than what I wanted to give.” Carer 1

Therefore, in this study the novel interdisciplinary model of care, positively affected both participant groups.

For People With PD and Carers Their Current Care Provision Is Disempowering and Burdensome

PwP and carers described the impact of being forced to travel for regular appointments for PD management because local care was “impossible.” They shared experience burdens that included requisite preparation, displacement from home and loss of symptom control:

“It’s impossible. For a neurologist, we need to go to [redacted metropolitan location].” Carer 1

In this study, no person with PD spoke of having telehealth as an option for PD specific consultations. Yet, they spoke of their desire for face-to-face consultations as opposed to having to travel, which had a significant impact on their physical, emotional, and financial wellbeing:

“Any sort of travel is challenging, I know when I fly, I get nervous, and I worry I’m going to have the tremor when I’m checking in.” PwP 2

For PwP and their carers, living in regional areas meant travel plans were often affected by infrequent daily flights, and the necessity of many hours of road travel just to reach the regional airport:

“It’s a huge day - I get up at 5:30 am to catch the first plane out. I’m already on my back foot because I’m tired and I don’t function properly. That’s why I take an escort with me.” PwP 1

This experience was not uncommon amongst the PwP and their carers:

“I have an early flight; it’s impacted on my medication [regime]. I need to take my medication earlier to be able to manage through the airport and then have it last so I can catch a taxi or bus when I get there.” PwP 2.

It resulted in a deterioration in the stability of the MS and NMS of PD.

“By the end of the day, I’m really struggling to walk, and I’m really tired by the end of it.” PwP 1

Travel was burdensome and they spoke of how it required significant preparation, disruption of daily routine, and a long recovery time for the physical and onerous emotional toll:

“We [person with PD and carer] now write a list so for everything we want ask [neurologist]. We plan, trying to prepare for the day - resting beforehand – and getting mentally aware it’s going to be a big day.” PwP 1

The emotional impact and evidence of an arduous journey to a metropolitan location to see a neurologist or movement disorder specialist for many PwP was unfortunately dismissed in their appointments compounding the burden:

“My neurologist said they deal with movement; they are not interested in feelings and stuff. So, when I get emotional, they seem a bit uncomfortable.” PwP 2

Notably, the impact of travel was also felt by carers of PwP who had to support and manage condition status changes like:

“Confusion, once [PwP4] is taken out of their normal routine, they experience fatigue, and confusion.” Carer 1

Changes in the current status of PD were noted to also require significant recovery time as suggested by PwP and their carers taking several days to weeks:

“at least two days. . .” PwP 2

“Well, probably a good week to get back to being normal.” PwP 1

“[PwP 4] was quite confused in the following week, disorientated, tired and exhausted.” Carer 1

Insight gained from stories of the cumulative impact of enforced travel, contributed to PwP’s dissatisfaction with current healthcare:

“Well, ideally it [healthcare] would be closer and less travel.” PwP 1

They were left questioning why travel was required and whether healthcare could be provided locally by stating:

“Whereas it would be good if you had a contact, such as a nurse, locally and not have to go to neurologist or doctor, but you still get access to those allied services. Ideally, having a face-to-face conversation is more reassuring.” PwP 1

Thus, insight into their desire to have local services was observed.

Regional Residing People With PD and Their Carers Seek Locally Accessible Healthcare With PD Skilled Clinicians

In this study, people with PD shared how they experienced care from a transient healthcare workforce which contributed to the lack of local PD expertise as evidenced by comments like:

“My doctor left [months ago], I’ve only seen one doctor since. So, now I’m feeling a little bit stuck.” PwP 2

Thus, it appears that a transient regional workforce contributes to the lack of confidence in healthcare experienced by PwP. Forging therapeutic relationships locally, whilst important, was not possible:

“It [the relationship] is very important to me because getting to know and feeling comfortable with someone is hard when you keep getting switched over and once again, they are not having the knowledge [to manage PD].” PwP 1

In the absence of local nursing, allied health, and medical expertise, they developed their own local support networks constituted by other PwP and carers, rather than local clinicians who were unskilled in PD management. Despite this, they did not cease in advocating for easily accessible, local, specialist services with clinicians who were knowledgeable about PD management and listed the following disciplines:

“Well definitely physiotherapy, it’s not just the tremor that affects me, its stiffness, the lack of movement, balance, there’s so many things that need to be addressed. An exercise physiologist has been marvellous. I’ve had feedback from a speech pathologist as a preventive measure for before you lose your voice, or it changes. Access to OT and the dietitian.” PwP 2

Overall, clinical academics and PwP suggested regional interdisciplinary care would be an asset to those living with the condition. However, future research is required to assess the economic implications and cost-effectiveness of implementing this novel PD interdisciplinary clinic in regional healthcare jurisdictions.

Discussion

Our research provides a new understanding and insights about the perceptions of clinical academics and regional PwP and carers on how much they valued the provision of local interdisciplinary PD care. Notably, the clinical academics placed value on how they “converged” and built “social capital” in the interdisciplinary clinic. For them convergence was the term used to describe the seamless connection, collaboration, and mutual ability to simultaneously assess and plan care for PwP. Wei ²⁸ recently described the development of an evidence-informed convergent care theory stating that 6 major facilitators are required namely, competence, compassion, accountability, trusting, sharing, and engaging. Our study demonstrated that skilled and competent clinical academics with a special interest in PD brought these attributes and used them to address not only the MS and NMS experienced by PwP but also their social, mental, and overall health. Further research may have been able to demonstrate the influence of this on long term outcomes for PwP and their carers. Moreover, whilst it was not an original aim of the investigation, the participating clinical academics, found the PD interdisciplinary clinic to be a positive and beneficial experience expanding their social capital. This finding was one that was contrary to their preconceived ideas about interdisciplinary care. However, as confirmed by Warren and Warren, ²⁹ a professional environment that promoted communication, respect for each discipline, and high morale was evident. Many challenges in healthcare teams have been described including accountability, conflict management, decision-making, reflecting on progress, and coaching ³⁰ but, these did not negate the positive experience of the clinical academics. In the literature, it has also been proposed that organizational arrangements, rules, suitable information structures and infrastructure along with a positive professional culture, willingness for cooperation and open communication is required for interdisciplinary care. ³¹ However, our study indicated that specialist clinical skills and a special interest in PD management was enough to foster interdisciplinary collaboration. Further research is required to understand how interdisciplinary care can be implemented in regional healthcare services when organizational arrangements are absent.

For regional PwP and their carers, their desire to be able to access local, PD skilled clinicians was strongly articulated. Their current management for PD was deemed disempowering and burdensome because extensive travel was often involved requiring extensive preparation, displacement from their home and loss of symptom control. Travel for a short appointment to a metropolitan location from a regional area was emotionally taxing and took days or weeks of recovery. Instead, a local interdisciplinary clinic provided them with an opportunity to better spend their time with clinicians developing effective management strategies for the problems that were important to them and their carers. However, further research is required to determine what disciplines should be included in regional interdisciplinary teams for PD.

PD as a chronic neurological condition contributes to the level of global disability. However, the literature informs us that most healthcare systems are not designed to meet the needs of patients with chronic neurological conditions like PD. ²⁰ In line with previous research, our study supports the findings of Bloem et al, ²⁰ when care for regionally located people with PD was fragmented and interdisciplinary collaboration was absent. When interdisciplinary care is absent, resultant care plans are more likely to be reactive, focused on the condition rather than the person and disempowering individuals from being integral decision-makers and contributors to the person-centred care approach they sought. Consequently, our findings were consistent with the study of Danoudis et al ³² on the healthcare experiences of PwP in Australia. In this study, the authors reported that PwP had poor experiences of healthcare related to the management of their condition. An outcome of our study that concurs with Danoudis et al, ³² is the need to prioritize an improvement of personalized healthcare provision and the introduction of continuity of care and collaboration between local interdisciplinary health professionals. Fabbri et al ³³ also agree and have proposed home-based, community-centred, integrated care as a solution for regional areas because it harnesses the potential of existing care resources, enabling self-management support for PwP.

The challenges of improving interdisciplinary care for PwP and their complex needs residing in regional environments, are well recognized. Thus, it is pertinent to co-design contextually relevant and person-centred regional PD services to capture their perceptions of a holistic and person-centred care healthcare service. The perceptions of PwP in this study were consistent with those of many PD experts^20,34,35 who recommend interdisciplinary care incorporates a person-centred approach with evidence-based PD management. This approach is likely to improve healthcare delivery for PwP and carers, and improve their QoL. ²² However, this is workload dependant and transient healthcare workforces are common in regional areas ³⁶ which is another issue warranting attention.

Our findings showcased the need for specialist PD nurses and allied health personnel for PD management in regional areas. In a previous study undertaken by Coady et al, ²³ confirming the impact of limited access to local PD specific care in regional Australia, the authors contended that specialist PD care can be effectively delivered by other clinicians. An example is specialist PD nurses, who would be capable of annulling accessibility barriers and promoting continuity of care. Furthermore internationally, multidisciplinary teams for PD have been proven to reduce the burden associated with complications due to falls, loss of independence and the implementation of person-centred treatment plans for the management of the wide variety of MS and NMS.^35,37 Such evidence provides the impetus for regional areas to develop strategies that will lead to an increased supply of skilled clinicians for PD management.

Moreover, to enhance regional PD management, clinicians require education in evidence-based PD practices. In our study, we identified an initial reservation by the clinical academics for working effectively in an interdisciplinary way. However, Cohen et al, ³⁸ have demonstrated that the development of interprofessional education programs in PD led to sustained positive gains in PD specific management knowledge and important practice improvements such as optimized teamwork. Future research is required on implementation and sustainability of interdisciplinary care provision for regional healthcare systems lacking PD specific services inclusive of people with PD and their carers.

Limitations

In this study qualitative perceptions were captured from clinical academics and PwP and their carers about their insights into regional interdisciplinary PD management. Due to the time limitations from seed grant funding, requiring the study to be completed within 12 months of receiving the grant, extensive member checking of the collected data was not possible for PwP or their carers. Moreover, the findings of the investigation may not be generalizable to other clinicians or PwP and their carers. However, the study findings may be transferable to regional healthcare systems with healthcare personnel lacking PD specific knowledge and skills. The findings may also contribute a small volume of data to the under-researched area of providing interdisciplinary care for PD in regional areas. Absent from the investigation were the thoughts and words of regional clinicians about their views of providing interdisciplinary PD care.

Conclusion

We found that implementing an interdisciplinary clinic for the management of PD in regional Australia was valuable to both clinical academics and PwP, and their carers. Clinical academics identified that interdisciplinary care enabled management of MS and NMS as well as empowering PwP to be self-managers. For PwP and their carers, local access to skilled clinical academics meant continuity of care, and maintenance of personal dignity. In addition, setting up an interdisciplinary PD clinic in a regional area meant the travel burden and loss of symptom control for PwP were minimized. However, future research is required to increase the expertise of clinicians for the provision of evidence-based interventions to improve the efficiency of healthcare provision for PD in regional Australia.

Supplemental Material

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Supplemental Material

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Supplemental material, sj-docx-3-jpc-10.1177_21501319241285349 for Perceptions of Clinical Academics and People With Parkinson’s Disease on Delivery of Regional Interdisciplinary Model of Care: Qualitative Descriptive Study by Sue Sharrad and Joanne Harmon in Journal of Primary Care & Community Health

Supplemental Material

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Supplemental material, sj-docx-4-jpc-10.1177_21501319241285349 for Perceptions of Clinical Academics and People With Parkinson’s Disease on Delivery of Regional Interdisciplinary Model of Care: Qualitative Descriptive Study by Sue Sharrad and Joanne Harmon in Journal of Primary Care & Community Health