Integrating Patient Concerns into Parkinson’s Disease Management

Abstract

Parkinson's disease (PD) is a complex motor and non-motor disorder and management is often challenging. In this review, we explore emerging approaches to improve the care of patients, drawing from the literature regarding patient-centred care, patient and caregiver perspectives and priorities, gaps in knowledge among patients and caregivers and the need for accurate information, individual variability in disease manifestations, prognostication of disease course, new developments in health technologies and personalized medicine, specialty care, pharmacological and non-pharmacological management, financial burden, lifestyle and work-related issues, support groups and palliative care.

The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson's disease: A systematic review and meta-analysis

“…A growing body of evidence supports the role of exercise in improving both motor and non-motor outcomes in PD[1–3]. In fact, exercise is now considered an integral part of the management of PD [4–6]. …”

Cognitive behavioral therapy improves diverse profiles of depressive symptoms in Parkinson's disease

“…Personalized care is especially relevant in a heterogeneous disorder such as PD, that is characterized by varied clusters of motor and nonmotor (psychiatric, autonomic, and GI) symptoms. It has been suggested that personalized medicine in PD should incorporate a variety of factors including symptom profiles, psychiatric comorbidities, and patient preference . The purpose of this study was to examine the impact of treatment response to CBT on different clusters of depressive symptoms in PD and to explore the extent to which stabilized ADM use moderated symptom change.…”

“…It has been suggested that personalized medicine in PD should incorporate a variety of factors including symptom profiles, psychiatric comorbidities, and patient preference. 28,36 The purpose of this study was to examine the impact of treatment response to CBT on different clusters of depressive symptoms in PD and to explore the extent to which stabilized ADM use moderated symptom change. To our knowledge, this is the first study to explore the extent to which specific symptom profiles in the depressed PD population can guide customized clinical recommendations.…”

The Parkinson Care Advocate: Integrating Care Delivery

“…Similar to the ParkinsonNet (17, 18) model, which involved standardization of physiotherapy for PD patients (17), this model emphasizes that PCAs undertake integrative (19, 20), educational roles within specific key cohorts, including those with poor treatment compliance, low health literacy (21), or advanced-stage disease. Akin to the diabetes educator (22) and other educational providers, implementation of PCAs portend improvements in clinical outcomes through fostering continuity of patient care, surmounting barriers in health literacy, coordinating tailored exercise sessions, and promoting cost-effective programs targeted at prevention (23).…”

“…PD patients obtain knowledge about their condition from their neurologists (20), whose abilities to engage in comprehensive disease counseling may be limited by time and resource constraints (4); from non-specialized consultants who patients may sparingly visit (13); and from the Internet, often a source of misinformation (24). Regardless of modality, acquiring accurate and actionable information about the disease is crucial.…”