Danique L M Radder1, Jorik Nonnekes2, Marlies van Nimwegen1, Carsten Eggers3, Giovanni Abbruzzese4, Guido Alves5, Nina Browner6, K Ray Chaudhuri7, Georg Ebersbach8, Joaquim J Ferreira9,10, Jori E Fleisher11, Peter Fletcher12, Giuseppe Frazzitta13, Nir Giladi14, Mark Guttman15, Robert Iansek16, Suketu Khandhar17, Jochen Klucken18,19, Anne-Louise Lafontaine20, Connie Marras21, John Nutt22, Michael S Okun23, Sotirios A Parashos24, Marten Munneke1, Bastiaan R Bloem1. 1. Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Nijmegen, The Netherlands. 2. Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation; Nijmegen, The Netherlands. 3. Department of Neurology, University Hospital of Marburg, Marburg, Germany. 4. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa - IRCCS Ospedale Policlinico San Martino, Genova, Italy. 5. The Norwegian Center for Movement Disorders, Department of Neurology, Stavanger University Hospital, Stavanger, Norway. 6. University of North Carolina, Movement Disorders Center, Chapel Hill, NC, USA. 7. Institute of Psychiatry, Psychology & Neuroscience, Parkinson Foundation International Center of Excellence, King's College Hospital, Denmark Hill, London, UK. 8. Movement Disorder Clinic Beelitz-Heilstaetten, Beelitz, Germany. 9. Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal. 10. CNS - Campus Neurológico Sénior, Torres Vedras, Portugal. 11. Rush University Medical Center, Chicago, IL, USA. 12. Cheltenham General Hospital, Gloucestershire, UK. 13. Moriggia-Pelascini Hospital, Gravedona ed Uniti, Gravedona, Italy. 14. Neurological Institute, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel. 15. Center for Movement Disorders, Toronto, Canada. 16. Kingston Center Monash Health, Melbourne, Australia. 17. Kaiser Permanente Sacramento Medical Center, Sacramento, CA, USA. 18. Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany. 19. Research Group Digital Health Pathways, Fraunhofer IIS, Erlangen, Germany. 20. Department of Neurology and Neurosurgery, McGill Movement Disorders Clinic, McGill University, Montreal, Canada. 21. The Edmond J Safra Program in Parkinson's disease and the Morton and Gloria Shulman Movement Disorders Center, Toronto Western Hospital, Toronto, Canada. 22. Oregon & Health Science University Hospital, Portland, OR, USA. 23. University of Florida Department of Neurology, Fixel Center for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Gainesville, FL, USA. 24. Struthers Parkinson's Center, Golden Valley, MN, USA.
Abstract
BACKGROUND: Optimal management in expert centers for Parkinson's disease (PD) usually involves pharmacological and non-pharmacological interventions, delivered by a multidisciplinary approach. However, there is no guideline specifying how this model should be organized. Consequently, the nature of multidisciplinary care varies widely. OBJECTIVE: To optimize care delivery, we aimed to provide recommendations for the organization of multidisciplinary care in PD. METHODS: Twenty expert centers in the field of multidisciplinary PD care participated. Their leading neurologists completed a survey covering eight themes: elements of optimal multidisciplinary care; team members; role of patients and care partners; team coordination; team meetings; inpatient versus outpatient care; telehealth; and challenges towards multidisciplinary care. During a consensus meeting, outcomes were incorporated into concept recommendations that were reviewed by each center's multidisciplinary team. Three patient organizations ranked the recommendations according to patient priorities. Based on this feedback, a final set of recommendations (essential elements for delivery of multidisciplinary care) and considerations (desirable elements) was developed. RESULTS: We developed 30 recommendations and 10 considerations. The patient organizations rated the following recommendations as most important: care is organized in a patient-centered way; every newly diagnosed patient has access to a core multidisciplinary team; and each team has a coordinator. A checklist was created to further facilitate its implementation. CONCLUSION: We provide a practical tool to improve multidisciplinary care for persons with PD at the organizational level. Future studies should focus on implementing these recommendations in clinical practice, evaluating their potential applicability and effectiveness, and comparing alternative models of PD care.
BACKGROUND: Optimal management in expert centers for Parkinson's disease (PD) usually involves pharmacological and non-pharmacological interventions, delivered by a multidisciplinary approach. However, there is no guideline specifying how this model should be organized. Consequently, the nature of multidisciplinary care varies widely. OBJECTIVE: To optimize care delivery, we aimed to provide recommendations for the organization of multidisciplinary care in PD. METHODS: Twenty expert centers in the field of multidisciplinary PD care participated. Their leading neurologists completed a survey covering eight themes: elements of optimal multidisciplinary care; team members; role of patients and care partners; team coordination; team meetings; inpatient versus outpatient care; telehealth; and challenges towards multidisciplinary care. During a consensus meeting, outcomes were incorporated into concept recommendations that were reviewed by each center's multidisciplinary team. Three patient organizations ranked the recommendations according to patient priorities. Based on this feedback, a final set of recommendations (essential elements for delivery of multidisciplinary care) and considerations (desirable elements) was developed. RESULTS: We developed 30 recommendations and 10 considerations. The patient organizations rated the following recommendations as most important: care is organized in a patient-centered way; every newly diagnosed patient has access to a core multidisciplinary team; and each team has a coordinator. A checklist was created to further facilitate its implementation. CONCLUSION: We provide a practical tool to improve multidisciplinary care for persons with PD at the organizational level. Future studies should focus on implementing these recommendations in clinical practice, evaluating their potential applicability and effectiveness, and comparing alternative models of PD care.
Authors: Jacqueline A Osborne; Rachel Botkin; Cristina Colon-Semenza; Tamara R DeAngelis; Oscar G Gallardo; Heidi Kosakowski; Justin Martello; Sujata Pradhan; Miriam Rafferty; Janet L Readinger; Abigail L Whitt; Terry D Ellis Journal: Phys Ther Date: 2022-04-01
Authors: Karen I Connor; Hilary C Siebens; Brian S Mittman; David A Ganz; Frances Barry; Donna K McNeese-Smith; Eric M Cheng; Barbara G Vickrey Journal: BMC Neurol Date: 2022-01-24 Impact factor: 2.474
Authors: Angelika D van Halteren; Marten Munneke; Eva Smit; Sue Thomas; Bastiaan R Bloem; Sirwan K L Darweesh Journal: J Parkinsons Dis Date: 2020 Impact factor: 5.568
Authors: Ana María Jiménez-Cebrián; Ricardo Becerro-de-Bengoa-Vallejo; Marta Elena Losa-Iglesias; Daniel López-López; César Calvo-Lobo; Patricia Palomo-López; Carlos Romero-Morales; Emmanuel Navarro-Flores Journal: Int J Environ Res Public Health Date: 2021-03-01 Impact factor: 3.390