An international 20 country patient and physician survey of the usability and acceptability of Stepped Care pathway in Parkinson’s disease

Parkinson's disease (PD) is not a single condition and has multiple heterogeneous presentations with several endophenotypes as well as collateral factors affecting care and health. However, clinical consultations globally often miss these important aspects in clinic. The Stepped Care pathway of care was developed from PD patients' opinion and attempts to combine these gaps in care in a simple 3-stage clinical paradigm. We conducted a survey across twenty (20) countries to explore the views of clinicians and PD patients on the process, acceptability and need of the Stepped Care pathway. A structured questionnaire was administered in both affluent and under-resourced clinics, capturing data from a multi-ethnic and diverse patient base. 99% patients (White, Asian and Black) felt Stepped Care toolkit asked relevant questions addressing needs and concerns in PD care that are often missed, and 96% agreed with the importance of using this toolkit during Outpatient Clinic visits. Moreover, a significant majority of PD patients (96%) felt Stepped Care makes them understand their condition better. 92% of clinicians indicated that the Stepped care toolkit could be an effective asset in clinical practice, while 91% of clinicians agreed that the toolkit provides holistic care which is often missed in clinic. This novel global survey of the efficacy and useability of Stepped Care for PD is overwhelmingly endorsed by PD patients and clinicians from a diverse, multi-ethnic background across high- and low- income countries. Stepped Care can be used in clinical practice in order to ensure a holistic and comprehensive care for PD.