Patientenperspektive auf die Versorgungssituation im Krankheitsbild Morbus Parkinson in Deutschland – eine Querschnittserhebung

Binder, Sebastian; Groppa, Sergiu; Woitalla, Dirk; Müller, Thomas; Wellach, Ingmar; Klucken, Jochen; Eggers, Carsten; Liersch, Sebastian; Amelung, Volker Eric

doi:10.1055/a-0624-1671

Cited by 10 publications

(13 citation statements)

References 18 publications

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“…It is expected that in 2040 more than 14 million people will suffer from PD, underlining the great impact of this disease on the health system now and in the future [7]. In order to improve early diagnosis and optimal therapy initiation in Parkinson’s patients, the widest possible availability of specific diagnostics and individualized treatment in a multiprofessional team is desirable [8,9].…”

Section: Introductionmentioning

confidence: 99%

Dynamics of Parkinson’s Disease Multimodal Complex Treatment in Germany from 2010–2016: Patient Characteristics, Access to Treatment, and Formation of Regional Centers

Richter

Bartig²,

Muhlack

et al. 2019

Cells

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Parkinson’s disease (PD) is currently the world’s fastest-growing neurological disorder. It is characterized by motor and non-motor symptoms which progressively lead to significant clinical impairment, causing a high burden of disease. In addition to pharmacological therapies, various non-pharmacological treatment options are available. A well established and frequently used multiprofessional inpatient treatment concept in Germany is “Parkinson’s disease multimodal complex treatment” (PD-MCT) which involves physiotherapists, occupational therapists, speech therapists, and other specializations for the optimization of treatment in PD (ICD G20) and other Parkinsonian syndromes (ICD G21 and G23). In this study we analyze the PD-MCT characteristics of 55,141 PD inpatients who have been integrated into this therapy concept in Germany in the years 2010–2016. We demonstrate that PD-MCT is increasingly applied over this time period. Predominately, PD patients with advanced disease stage and motor fluctuations in age groups between 45 and 69 years were hospitalized. In terms of gender, more male than female patients were treated. PD-MCT is provided primarily in specialized hospitals with high patient numbers but a minor part of all therapies is performed in a rather large number of hospitals with each one treating only a few patients. Access to PD-MCT differs widely across regions, leading to significant migration of patients from underserved areas to PD-MCT centers – a development that should be considered when implementing such therapies in other countries. Furthermore, our data imply that despite the overall increase in PD-MCT treatments during the observational period, the restricted treatment accessibility may not adequately satisfy current patient´s need.

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Section: Introductionmentioning

confidence: 99%

Dynamics of Parkinson’s Disease Multimodal Complex Treatment in Germany from 2010–2016: Patient Characteristics, Access to Treatment, and Formation of Regional Centers

Richter

Bartig²,

Muhlack

et al. 2019

Cells

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“…PD care in Germany involves a large number of different healthcare providers and is hindered by fragmentation, lack of communication and coordination [6]. Although defined as a standard of care, the access to specialized treatment is highly limited, aggravating imbalances in care access and hampering the efficient delivery of individualized, multiprofessional care [7].…”

Section: Introductionmentioning

confidence: 99%

“…This will be addressed by several strategies including: the structured acquisition of participants due to personal on-site consultations; releasing information updates about the network status; organization of educational symposiums; project discussion groups; topic-specific workgroups; stakeholder meetings and regional quality circles ( Table 7, ANM 1,5,6). No consensus could be achieved on an adequate frequency of plenary meetings.…”

mentioning

confidence: 99%

Parkinson Network Eastern Saxony (PANOS): Reaching Consensus for a Regional Intersectoral Integrated Care Concept for Patients with Parkinson’s Disease in the Region of Eastern Saxony, Germany

Loewenbrück

Stein²,

Amelung³

et al. 2020

JCM

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As integrated care is recognized as crucial to meet the challenges of chronic conditions such as Parkinson’s disease (PD), integrated care networks have emerged internationally and throughout Germany. One of these networks is the Parkinson Network Eastern Saxony (PANOS). PANOS aims to deliver timely and equal care to PD patients with a collaborative intersectoral structured care pathway. Additional components encompass personalized case management, an electronic health record, and communicative and educative measures. To reach an intersectoral consensus of the future collaboration in PANOS, a structured consensus process was conducted in three sequential workshops. Community-based physicians, PD specialists, therapists, scientists and representatives of regulatory authorities and statutory health insurances were asked to rate core pathway-elements and supporting technological, personal and communicative measures. For the majority of core elements/planned measures, a consensus was reached, defined as an agreement by >75% of participants. Additionally, six representatives from all partners involved in the network-design independently assessed PANOS based on the Development Model for Integrated Care (DMIC), a validated model addressing the comprehensiveness and maturity of integrated care concepts. The results show that PANOS is currently in an early maturation state but has the potential to comprehensively represent the DMIC if all planned activities are implemented successfully. Despite the favorable high level of consensus regarding the PANOS concept and despite its potential to become a balanced integrated care concept according to the DMIC, its full implementation remains a considerable challenge.

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“…Moreover, another cross-sectional study analyzed the care situation from the patients’ perspective. On average, patients rated the usage of nonpharmacological therapies as insufficient (scale: from “0 = not at all sufficient” to “5 = absolutely sufficient”), with mean ratings of 2.3 (SD: ± 2.0) for occupational therapy, 2.4 (SD: ± 2.0) for speech therapy, and 3.0 (SD: ± 1.7) for physical therapy [ 18 ]. Compared to international standards, the potential of nonpharmacological therapies in Germany has not yet been exploited [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Network relations assume that coordination between actors is based on mutual benefit, reciprocity, and confidence [ 19 ]. The treatment within such networks shows potential to better integrate therapies into daily life [ 18 ]. Current models of care try to follow multidisciplinary approaches, which are often mistaken for interdisciplinary approaches.…”

Section: Introductionmentioning

confidence: 99%

Quickcard-Based Approach to Guiding Specific Nonpharmacological Treatments in a German Parkinson’s Network

Kerkemeyer¹,

Achtert²,

Claus

et al. 2020

JCM

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Interdisciplinary care has been shown to be effective at optimizing the treatment of patients with Parkinson’s disease. An optimized collaboration between the various healthcare providers involved in the treatment process facilitates successful care. One of the main shortcomings in the German healthcare system is the limited and unstandardized communication between practitioners. The Parkinson’s network Münsterland+ (PNM+) is an interdisciplinary network of medical and non-medical experts involved in the treatment of Parkinson’s patients: neurologists, physiotherapists, occupational therapists, speech therapists, psychologists, Parkinson’s nurses, pharmacists, patients, and relatives. The PNM+ elaborates guideline-based therapy recommendations, provided as so-called “Quickcards”. Thereby, the communication of the treating neurologist and therapists is based on a coordinated feedback system and suggestions to adequately select and, if necessary, adjust the therapy. In the German healthcare system, with its fragmented structures, the PNM+ and its activities have been shown to enhance integration of the healthcare providers and thereby optimize the care of Parkinson’s disease patients. Future research should evaluate the effects and cost-effectiveness.

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Patientenperspektive auf die Versorgungssituation im Krankheitsbild Morbus Parkinson in Deutschland – eine Querschnittserhebung

Cited by 10 publications

References 18 publications

Dynamics of Parkinson’s Disease Multimodal Complex Treatment in Germany from 2010–2016: Patient Characteristics, Access to Treatment, and Formation of Regional Centers

Dynamics of Parkinson’s Disease Multimodal Complex Treatment in Germany from 2010–2016: Patient Characteristics, Access to Treatment, and Formation of Regional Centers

Parkinson Network Eastern Saxony (PANOS): Reaching Consensus for a Regional Intersectoral Integrated Care Concept for Patients with Parkinson’s Disease in the Region of Eastern Saxony, Germany

Quickcard-Based Approach to Guiding Specific Nonpharmacological Treatments in a German Parkinson’s Network

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