A Model of Hospital-Territory Management Coordinated by a Case Manager to Improve the Care of Patients With Parkinsonism.

The present multicenter randomized study investigates whether the management of patients with parkinsonism by a nurse specialist (case-manager) can significantly improve patients' quality of life over 12 months, compared to control patients managed with the standard-of-care process. Participants will be evaluated with clinical scales testing quality of life, motor and non-motor symptoms, and the number of unscheduled hospital access throughout the course of the study.

Inclusion Criteria: * Age ≥ 18 years * Living in the Lombardy region (Northern Italy) * Duration of Parkinson's disease, atypical or secondary parkinsonism ≥ 3 years * Presence of at least (i) n=1 motor complication and/or (ii), n=2 non-motor symptoms, defined as follows: (i) Motor complication: * Motor fluctuations * ≥ 2 Falls in the last 6 months * Dysphagia (ii) Non Motor symptoms * Non-motor fluctuations * ≥ 2 items of the non-motor symptoms scale with a score ≥ 2 Exclusion Criteria: * Hoehn and Yahr Stage = 5 in the ON-medication condition * Psychiatric comorbidity or other neurological chronic diseases that, in the opinion of the recruiting neurologist, could compromise the study participation. * Patients on infusional therapies (continuous infusion of levodopa-carbidopa intestinal gel or Continuous Subcutaneous Apomorphine Infusion). * Severe medical disease (liver or kidney failure, decompensated heart disease, neoplasms, coagulopathy)