Parkinson's quality measures spotlight symptom awareness

Doctors are encouraged to assess symptoms regularly and counsel patients on how to prevent complications.

By — Posted Dec. 14, 2010

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New quality indicators for Parkinson's disease could help physicians treat the condition by highlighting symptoms they should pay attention to when diagnosing the disorder, according to the lead author of the new measures.

Such symptoms include depression, insomnia, falls and hallucinations.

The measures, which were published in the Nov. 30 issue of Neurology, were developed by a 28-member panel selected by the American Academy of Neurology. The panel, which included movement disorder specialists, reviewed Parkinson's guidelines. The AAN's Board of Directors approved the 10 quality indicators in December 2009.

"The most dramatic outward feature of Parkinson's disease is the tremors. But we wanted to make sure that when patients are cared for, some of these other nonmotor symptoms are being assessed properly," said lead author Eric M. Cheng, MD, assistant professor of neurology at the David Geffen School of Medicine at UCLA.

"I think all conditions deserve some sort of tool to determine if certain patients are not getting optimal care," he said.

An estimated 1 million Americans have Parkinson's disease, according to the AAN, with the majority of cases in adults 50 and older.

The new quality measures assess symptoms of Parkinson's, especially nonmotor symptoms, including depression and falling (link).

These indicators encourage physicians to re-evaluate a patient's Parkinson's diagnosis and treatment regimens at least once a year. Medical issues, such as a stroke or different types of dementia, can have symptoms similar to those of the progressive neurologic disorder, Dr. Cheng said.

The measures also urge doctors to discuss with patients how to prevent complications related to their disease stage, including injuries from falling and forgetting to take medication. The measures do not recommend the use of specific drugs, assessment tools or treatment options.

"Primary care providers know how to do a lot of screens, such as fall assessments and depression assessments. We don't want to tell them how to do it. But we want to remind them that [there are symptoms that are] a particular concern for Parkinson's patients," Dr. Cheng said.

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