Addressing knowledge gaps in Parkinson’s disease: a report on the Movement Disorder Society’s Centre-to-Centre initiative to improve Parkinson’s disease services in Lao People’s Democratic Republic

Abstract

Background: Lao People's Democratic Republic (Lao PDR) has only nine neurologists for seven million people; none have formal training in Parkinson's disease (PD). Medical specialists require sufficient PD knowledge to provide high-quality care. Methods: This study outlines a Centre-to-Centre programme for developing PD expertise in underserved regions through a tailored two-year educational enterprise between an established movement disorder mentor centre at Chulalongkorn University in Thailand and mentee centres in Lao PDR. Background knowledge of 80 Laotian physicians was assessed using a validated PD knowledge questionnaire containing 26 questions divided into 3 sections (diagnosis, therapeutic options, disease course) before and immediately after one-day kick-start training. Responses were compared across physicians' demographic groups. Results: Of 80 respondents, 50 (62.5%) were board-certified physicians, of which 27 (54%) specialised in internal medicine. Apparent knowledge gaps were shown by a 51.2% correct response rate for total score, 52.8% for diagnosis, 50.6% for therapeutic options, and 48.2% for disease course. No significant differences in total score or any domain sub-scores between neurologists and other specialties were found. Many did not know which non-motor symptoms could occur as prodromal symptoms or late in course of PD. Incorrect responses mainly reflected a lack of knowledge of the impact of medication on disease. Total and domain sub-scores significantly improved after the course (p < 0.05, each). The size of difference of the means was

Knowledge about sudden unexpected death in Parkinson´s disease among speech-language pathologists and audiologists

“…A research conducted in Lao (The Lao People's Democratic Republic) found that the greatest lack of knowledge among doctors is in relation to non-motor symptoms and the impact of drugs on PD (Phokaewvarangkul, et al, 2020). In Thailand, a group of researchers detected gaps in the knowledge of neurologists, residents, intensivists, general practitioners and nurses about diagnosis, pharmacological options, and progression of PD, thus, the authors suggested didactic training, conference presentations, journal articles, meetings and small group discussions to promote the professionals' reflection on the phenomenon so that this knowledge gap is filled (Bhidayasiri, et al, 2014).…”

“…Despite the number of studies addressing the knowledge of health professionals correlating with PD (Cohen, et al, 2016, Phokaewvarangkul, et al, 2020Bhidayasiri, et al, 2014;Skelly, et al, 2015;Van Rumund, et al, 2014), a lack of research on the knowledge of SUDPAR among them is observed, reflecting the urgent need to use educational strategies so that the concept of SUDPAR is recognized among health professionals in order to prevent the tragic outcome in PD patients.…”