# Reaching the Most Vulnerable: A Novel Model of Care in Advanced Parkinson's Disease

> **NIH NIH K23** · RUSH UNIVERSITY MEDICAL CENTER · 2021 · $183,356

## Abstract

PROJECT SUMMARY/ABSTRACT
As Parkinson's Disease (PD) progresses, the symptoms of this debilitating and costly condition increase in
number and severity, quality of life declines, and caregiver strain rises, resulting in 100-200,000 US patients
becoming homebound. This population loses access to care despite overwhelming need. Evidence supports
interdisciplinary and home-based models of care in other elderly cohorts, and the use of telehealth in earlier
stages of PD; however, none of these have been formally tested in advanced PD. The long-term goals of this
K23 are 1) to develop the candidate into a leader in the fields of movement disorders and health services
research, and 2) to develop, test, and disseminate models of care and related interventions to improve access
to care, quality of care, and quality of life for patients with advanced PD and their caregivers. The aims of this
project are 1) to test the efficacy of an interdisciplinary home visit program for patients with advanced PD on
patient quality of life and caregiver strain when compared with usual care; 2) to compare the effects of home
visits with and without caregiver peer mentoring on caregiver health; and 3) to conduct a budget impact
analysis of the model. We will prospectively study 60 patient-caregiver pairs matched with subjects receiving
usual care within the National Parkinson Foundation Parkinson's Outcome Project (POP); we will enroll 36
experienced past caregivers as peer mentors. The K23 candidate is an Assistant Professor of Neurology and
Population Health at New York University School of Medicine, and completed a movement disorders fellowship
and NINDS T32-supported Master's of Science in Clinical Epidemiology at the University of Pennsylvania. She
has conducted clinical and health services research in geriatrics, neurology, and PD, identifying health literacy
and medication beliefs as barriers to care. She has demonstrated the feasibility of a pilot interdisciplinary home
visit program for homebound individuals with PD. The candidate is committed to a career in patient-oriented
research and proposes an comprehensive five-year plan of mentorship, formal training, self-directed learning,
and research. She will develop expertise and skills in: 1) Implementation and dissemination science; 2)
Comparative and cost effectiveness research; and 3) Palliative care skills and research. The results of this K23
will inform future R01 applications that will test the efficacy and cost effectiveness of this model for advanced
PD in other settings, and adapt this model to other chronic neurologic conditions. By identifying, testing, and
disseminating effective therapies and models of care for this previously understudied population, we can
minimize morbidity and unnecessary healthcare utilization. Dr. Fleisher's mentorship team includes expertise in
PD, implementation and dissemination of interdisciplinary care models, telehealth, cost effectiveness, and the
POP. The outstanding inst...

## Key facts

- **NIH application ID:** 10226958
- **Project number:** 5K23NS097615-05
- **Recipient organization:** RUSH UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Jori Erin Fleisher
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $183,356
- **Award type:** 5
- **Project period:** 2017-09-25 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10226958

## Citation

> US National Institutes of Health, RePORTER application 10226958, Reaching the Most Vulnerable: A Novel Model of Care in Advanced Parkinson's Disease (5K23NS097615-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10226958. Licensed CC0.

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