Netzwerke zur Versorgung Parkinsonerkrankter

Ziegler, Kerstin; Hoppmann, Dagmar; Loidl, Verena; Wagner, Christian; Schroeteler, Frauke; Fietzek, Urban; Hermann, Margit; Grill, Eva; Ceballos-Baumann, Andrés

doi:10.1055/a-1546-1883

Cited by 2 publications

(4 citation statements)

References 45 publications

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“…The intervention consists of three stage-specific and symptom-specific physiotherapy programmes developed within the PaNTher project, which involved neurologists and physiotherapists specialised in movement disorders with experience in treating PD (table 2). The intervention and its development have been described in detail elsewhere 26. In brief, each programme comprises one basic and up to four special therapy packages.…”

Section: Methods and Analysismentioning

confidence: 99%

“…The intervention and its development have been described in detail elsewhere. 26 In brief, each programme comprises one basic and up to four special therapy packages. Therapy duration, frequency and extent as well as content and aims depend on the stage of the disease and are based on the European physiotherapy guidelines.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Physiotherapists are specially trained to carry out these programmes. 26 We hope that the PaNTher network will improve the practice of treatment and outcomes of patients with PD in outpatient care. Therefore, the objective of this study is to evaluate the implementation of a pragmatic network for the care of PD, Parkinson's Network Therapy (PaNTher).…”

Section: Open Accessmentioning

confidence: 99%

“…Being part of the network allows an outpatient neurologist to offer patients the model project and prescribe physiotherapy programmes, which are tailored to the specific symptoms and stages of the disease. Physiotherapists are specially trained to carry out these programmes 26…”

Section: Introductionmentioning

confidence: 99%

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Implementation and the effects of a Parkinson Network Therapy (PaNTher) on activities of daily living and health-related quality of life in Parkinson’s disease patients: study protocol of an mixed-method observational cohort study in outpatient care

Loidl,

Ziegler,

Hoppmann

et al. 2023

BMJ Open

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IntroductionParkinson’s disease (PD) represents the fastest growing neurodegenerative disease with an increasing prevalence worldwide. It is characterised by complex motor and non-motor symptoms that lead to considerable disability. Specialised physiotherapy has been shown to benefit patients with PD. TheParkinson Netzwerk Therapie(PaNTher) was created to improve access to specialised physiotherapy tailored to care priorities of PD patients. This study aims to evaluate the effectiveness, acceptability and needs of the PaNTher network by neurologists and physiotherapists involved in the network in outpatient care.Methods and analysisThis is a mixed-method, prospective, pragmatic non-randomised cohort study of parallel groups, with data collection taking place in Bavaria, Germany, between 2020 and 2024. Patients with PD insured by theAllgemeine Ortskrankenkasse Bayern(AOK Bayern) living in Bavaria will be recruited for study participation by network partners. Patients in the intervention group must reside in Munich or the surrounding area to ensure provision of specialised physiotherapy in close proximity to their place of residence. Controls receive care as usual. Six and 12 months after baseline, all patients receive a follow-up questionnaire. Mixed-effect regression models will be used to examine changes in impairment of activities of daily living and quality of life of patients with PD enrolled in the programme over time compared with usual care. Qualitative interviews will investigate the implementation processes and acceptability of the PaNTher network among neurologists and physiotherapists. The study is expected to show that the PaNTher network with an integrative care approach will improve the quality and effectiveness of the management and treatment of patients with PD.Ethics and disseminationThe study has been approved by the ethics committee at the medical faculty of the Ludwig-Maximilians-University Munich (20-318). Results will be published in scientific, peer-reviewed journals and presented at national and international conferences.

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Section: Methods and Analysismentioning

confidence: 99%

Section: Methods and Analysismentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Implementation and the effects of a Parkinson Network Therapy (PaNTher) on activities of daily living and health-related quality of life in Parkinson’s disease patients: study protocol of an mixed-method observational cohort study in outpatient care

Loidl,

Ziegler,

Hoppmann

et al. 2023

BMJ Open

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Parkinson-Syndrom

Ceballos-Baumann

2022

Dtsch Med Wochenschr

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Was ist neu? Klinik Die Prävalenz des idiopathischen Parkinson Syndroms (IPS) wird sich bis 2030 verdoppeln. Das IPS ist nicht mehr als eine in sich geschlossene Krankheitsentität zu betrachten. Monogenetische Formen können klinisch identisch zu dem sporadischen IPS erscheinen. Eine Mutation im Glucozerebrosidase-Gen lässt sich bei > 5 % der Patienten nachweisen und steigert das Risiko an Parkinson zu erkranken um 8–20-mal. COVID-19 Die Corona-Pandemie hat zu einer Verschlechterung der Symptomatik vieler Parkinson-Patienten geführt. In der Zeit hat man gelernt, dass Videosprechstunden sich für die Betreuung von Parkinson-Patienten eignen. Auch die motorischen Symptome sind gut zu beurteilen. Pharmakotherapie Die schon Jahrzehnte bestehende Kontroverse, ob der Einsatz von Levodopa hinausgezögert werden sollte, bildete erneut den Hintergrund einer aufwendigen Studie. Bei Vergleich zwischen frühem versus verzögerten Beginn von Levodopa konnte nach ca. 2 Jahren kein signifikanter Unterschied im Parkinson-Schwergrad festgestellt werden. Auch die Rate an Dyskinesien war nicht unterschiedlich. Unter Dopaminagonisten kam es in einer Studie mit > 400 Patienten innerhalb von 5 Jahren zu einer Häufigkeit von 52 % von Impulskontrollstörungen. In den letzten 10 Jahren sind in Deutschland für die Parkinson-Therapie nur 2 neue Substanzen auf den Markt gekommenen, beide mit der Indikation Zusatztherapie zu Levodopa bei Patienten mit Wirkungsschwankungen. Geräte unterstützte Therapien Der Einsatz der tiefen Hirnstimulation und Medikamentenpumpen bei Patienten mit Levodopa-Wirkungsfluktuationen wächst, denn an diesem Punkt des Krankheitsverlaufs angekommen, nehmen Patienten auch invasive Therapien im Kauf, die die Unabhängigkeit verlängern und optimieren können. Patienten, die Levodopa mehr als 5-mal täglich benötigen und trotz optimaler nicht Levodopa-basierter Therapien schwere, störende OFF-Phasen (> 2 Stunden am Tag) haben, können prinzipiell diese Therapieoptionen erwägen. Über 90 % der Patienten ziehen es vor, an der Entscheidungsfindung beteiligt zu sein, welche der Geräte-unterstützten Therapie zum Einsatz kommt. Evidenzbasierte aktivierende Therapien und netzwerkbasierte Versorgungsmodelle Parkinson-Stadien- und symptomfokussierte, leitlinienbasierte Physiotherapie wirken sich positiv auf Krankheitsverlauf, Alltagsleistungen und Lebensqualität aus und vermindern die Sturzgefahr. Berufsgruppen- und Sektoren-übergreifende Netzwerke erweisen sich als effektiv, Stürze und Krankenhauseinweisungen zu senken.

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Netzwerke zur Versorgung Parkinsonerkrankter

Cited by 2 publications

References 45 publications

Implementation and the effects of a Parkinson Network Therapy (PaNTher) on activities of daily living and health-related quality of life in Parkinson’s disease patients: study protocol of an mixed-method observational cohort study in outpatient care

Implementation and the effects of a Parkinson Network Therapy (PaNTher) on activities of daily living and health-related quality of life in Parkinson’s disease patients: study protocol of an mixed-method observational cohort study in outpatient care

Parkinson-Syndrom

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