Designing a care pathway for high risk parkinson’s patients

Abstract

<jats:sec><jats:title>Objective</jats:title><jats:p>To inform pathway design for patients at high risk of an adverse outcome at 5 years post-Parkinson’s disease (PD) diagnosis.</jats:p></jats:sec><jats:sec><jats:title>Background</jats:title><jats:p>In our service, all newly diagnosed patients follow a 12 month new patient pathway, which includes assessment with PDQ-39, NMS Quest and MOCA. Use of a prognostic calculator<jats:sup>1</jats:sup> allows for refinement of the pathway according to patient need. Patients are classified as low (0–0.3), medium (0.31–0.79) or high (0.8–1) risk of an adverse outcome at 5 years (postural instability, dementia, death).</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>We aim to evaluate whether assessments in the newly diagnosed pathway identify additional care needs in higher risk patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>An evaluation was carried out of our new patient database. Individuals who had the prognostic indicator performed (n=52) were included in the evaluation.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Patients in the high risk groups were found to be older and more cognitively impaired than lower risk patients (p&lt;0.05). MOCA scores negatively correlated with NMS Quest (r=−0.44, p&lt;0.001) and PDQ-39 (r=−0.51, p&lt;0.001) suggesting as cognition becomes impaired, NMS burden increases, and quality of life is reduced.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Additional care needs were identified in high-risk patients. These findings highlight additional resources are required in this patient cohort to ensure needs are met.</jats:p></jats:sec><jats:sec><jats:title>Reference</jats:title><jats:list list-type="order"><jats:list-item><jats:p>. Velseboer DC, et al. Development and external validation of a prognostic model in newly diagnosed Parkinson disease.</jats:p></jats:list-item></jats:list></jats:sec>