Experts Highlight 5 NICE Guidelines for Parkinson’s Patients and Clinicians to Follow

In 2017, the United Kingdom’s National Institute for Health and Care Excellence (NICE) published its latest guidelines on how adult patients and their caregivers should manage Parkinson’s disease (PD).
In a new commentary, four experts discuss the implications of some of these recommendations for both patients and healthcare professionals, highlighting the importance of clear communication between both parties to ensure the best management for this chronic disease.
The article, “Highlighting the goals for Parkinson’s care: commentary on NICE Guidelines for Parkinson’s in Adults (NG71),” was published in Age and Ageing.
Parkinson’s disease, the second most prevalent neurodegenerative disease in the elderly after Alzheimer’s disease, is a complex, multifactorial disorder characterized by the gradual loss of muscle control, sometimes accompanied by cognitive deficits.
So far, several models of care provision have attempted to summarize recommendations for both Parkinson’s patients and clinicians.
In this article, the authors discussed the implications of five different aspects of Parkinson’s disease highlighted in the Parkinson’s disease NICE quality standard, derived from the full NICE guidelines published previously.
First, the quality standard recommends that patients always remain in contact with a healthcare specialist to ensure continuous disease monitoring and to help with informed decision-making.
“Ensuring that a point of contact with specialist services is available for people with PD is vital for maintaining continuity of care and providing access to information, advice, care and support when people with PD, their families and carers need it,” the authors wrote.
Second, patients on dopaminergic medications should be aware of the risks of developing impulse control disorders (ICDs) — a type of personality disorder characterized by the inability to resist impulses to engage in excessive or harmful behaviors — that have been associated with levodopa and dopaminergic agonists used in the treatment of Parkinson’s.
“A better understanding of the risk of ICDs can ensure they are detected earlier and help patients understand the need to reduce their dopamine therapy and engage with cognitive behavioral therapy,” the authors wrote.
Third, patients with balance issues, severe motor symptoms, and difficulties with daily life activities, including problems with communication, swallowing, or saliva, should be referred to supportive therapies, such as physiotherapy, occupational therapy, or speech and language therapy.
“The broader impact that these symptoms have on activities of daily living requires a multi-disciplinary team approach to treatment. For clinicians this means having an awareness of the multi-system nature of the condition and the impact it can have on lifestyle. Discussing this with people with PD should prompt referral to the appropriate multi-disciplinary team member,” the authors wrote.
Fourth, patients admitted to a hospital or care home should take levodopa within 30 minutes of their usual prescribed administration time to avoid the occurrence of acute akinesia, or the inability to move voluntary muscles, and neuroleptic malignant syndrome, which is a life-threatening adverse reaction to certain anti-psychotic medications.
“The goal of current clinicians should be to take steps to … [ensure] staff training and understanding of the importance of prompt administration of levodopa,” the authors said.
Finally, healthcare professionals should provide clozapine to patients who are experiencing hallucinations and delusions that could occur as a side

Source: Parkinson's News Today

Parkinson’s Foundation Holding Upcoming Team Training Program for Healthcare Professionals in Atlanta

The Parkinson’s Foundation’s next education program course for healthcare professionals who treat Parkinson’s patients will be held in Atlanta, the nonprofit announced in a press release.
Called Allied Team Training for Parkinson’s (ATTP), the three-day program will take place Oct. 17-20, with Emory University and the Medical College of Georgia — both Parkinson’s Foundation Centers of Excellence — serving as course partners.  
A Center of Excellence is an academic medical center with a specialized team of healthcare professionals who are on top of the latest Parkinson’s medications, therapies, and research. Globally, the foundation has 45 Centers, including 31 in the U.S.
Since 2002, ATTP has trained more than 2,000 healthcare professionals in North America. The curriculum comprises best practices based on cutting-edge research using a team-based approach. The course includes interactive case presentations and care planning with Parkinson’s patients and caregivers; patient and caregiver panels; and opportunities to network with national and regional health professionals.
“The Parkinson’s Foundation is committed to providing healthcare professions with the latest research and best practices that improve care for people living with Parkinson’s disease,” said John L. Lehr, president and CEO of the Parkinson’s Foundation. “Attendees will learn to deliver personalized and patient-centered care at the right time throughout the continuum of the disease.”
The program is designed for physicians, nurse practitioners, nurses, physician assistants, occupational therapists, speech language therapists, physical therapists, and social workers. Working in teams, participants will learn the best ways to care for those living with Parkinson’s.
Faculty will consist of senior movement disorder specialists. Go here for more information on what the course entails, and how to apply.
Registration rates are $500 per person, or $450 per person for teams of three or more. There is no charge for students and medical doctor fellows.
“Allied Team Training for Parkinson’s will change my group practice and how we interact as a team, which is critically important so that we can work together more efficiently and provide better care,” said George Wong, a board-certified neurologist and co-director of the Jared Neuroscience Center in Springfield, Missouri.
Future ATTP programs are slated for the University of Iowa (spring 2019), the Medical University of South Carolina (fall 2019), Massachusetts General Hospital (spring 2020), Struthers Parkinson’s Center in Minnesota (fall 2020), Oregon Health & Science University (spring 2021), and University of Kansas Medical Center (fall 2021).
“Allied Team Training for Parkinson’s fills an important educational need for practicing healthcare professionals by providing updates in assessment and treatment with simultaneous training in inter-professional team-based care,” said registered nurse and movement disorder specialist Ruth Hagestuen, who founded ATTP.
A particularly innovative and important course aspect has each participant developing treatment plans based on their own care setting and community, Hagestuen said.
For more information on the Parkinson’s Foundation’s other professional educational offerings, go here.
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Source: Parkinson's News Today