In order to determine primary health care providers’ (PCPs) knowledge gaps on Parkinson’s disease, data was collected before and after a one-hour continuing medical education (CME) lecture on early Parkinson’s disease recognition and treatment in a sample of 104 PCPs participating at an annual meeting. The main outcome measure was the proportion of questions answered correctly by each PCP before the lecture. We measured the change in proportion of correct answers before and after the lecture (delta). Ninety-nine percent of the PCPs who attended the lecture returned the questionnaire. The level of knowledge on Parkinson’s disease before the lecture was relatively low, particularly in management (61.4%) and diagnosis (34.4%). PCPs’ perceived knowledge was not associated with the number of correct responses on management at baseline. Test scores significantly improved after the CME lecture. Our results show that PCPs’ baseline knowledge of diagnosis and management of Parkinson’s disease and self-perceived knowledge on this topic are relatively limited. Appropriately, US reaccreditation programs do not only rely on self-perception. Longitudinal studies are needed to determine the impact of CME in knowledge retention and patient care in Parkinson’s disease.
The goal of this thesis is to determine if neuropsychiatric features can differentiate parkinsonian patients with: tauopathies from those with alpha-synucleinopathies and explore caregiver distress. Three hundred and four patients (62 with tauopathies and 242 with alpha-synucleinopathies) diagnosed according to published diagnostic criteria were evaluated using the Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), and Unified Parkinson's Disease Rating Scale (UPDRS). To control for between-group differences a subsample of235 patients were analyzed. Patients with tauopathies had significantly higher NPI total scores, more apathy, less hallucinations, lower MMSE scores and higher UPDRS scores than those with alpha-synucleinopathies. Hallucinations and delusions were not related to levodopa or dopamine agonist daily doses, but increased age was associated with these disturbances. There were moderate correlations between caregiver distress and severity of neuropsychiatric disturbances. Despite between-group neuropsychiatric differences at early stages, the symptom overlap does not allow to classify patients with these two proteinopathies.
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