Integrated and patient-centred management of Parkinson's disease: a network model for reshaping chronic neurological care

Abstract

Chronic neurological diseases are the leading source of disability globally. Yet, our healthcare systems are not designed optimally to meet the needs of the many chronic neurological patients. Care is fragmented, with poor interdisciplinary collaboration and lack of timely access to services and therapies. Furthermore, care is typically reactive, and complex problems are managed inadequately due to lack of disease-specific expertise and insufficient use of non-pharmacological interventions. Treatment plans tend to focus on the disease rather than the individual living with it, and patients are insufficiently involved in clinical decision making. Utilising Parkinson's disease as a model condition, we illustrate an integrated care concept with a patient-centred perspective that includes evidence-based solutions to tackle the limitations of current healthcare delivery for people with chronic neurological conditions. We anticipate that this integrated care model will improve the quality of lives of patients and create an attractive working environment for professionals, whilst being affordable for future generations. [151 words] Search strategy and selection criteria We searched for publications on healthcare and neurological conditions (in particular Parkinson's disease) published in MEDLINE from 1 January 1990 to 28 January 2020, using comprehensive electronic search strategies combining MeSH and free text search terms "chronic", "care", "network", "patientcenteredness", "integrated", "multidisciplinary", "interdisciplinary", "technology", "health services", "wearable sensors", "telemedicine", "Parkinson disease" and "Parkinson's disease", without language restrictions. Selected articles were also obtained from the reference lists of papers identified by the PubMed search and from searches of the authors' own files. We included both original studies and viewpoints.

Saturdays-in-Motion: Education and Empowerment through an Interdisciplinary Team Approach for Parkinson’s Disease in Cali-Colombia

“…is initiative agrees with programs such as Par-kinsonNet, where the aim roots for the empowerment of patients due to the positive effects on mood symptoms and quality of life, as well as the fact that it makes it less likely to seek medical support and this reduces healthcare costs [30].…”

A New Day: The Role of Telemedicine in Reshaping Care for Persons With Movement Disorders

“…Yet current Parkinson's care frequently fails to meet any of these aims. 12,21 Patient-Centered Care In Parkinson's care, the patient is the sun, not the physician and certainly not the clinic. Services should revolve around the patient's needs.…”

“…Because of these and many other disadvantages with routine care, the National Academy of Medicine wrote in 2001, “Between the health care we have and the care we could have lies not a gap, but a chasm.” 20 To cross the chasm, health care should be safe, effective, patient‐centered, timely, efficient, and equitable. Yet current Parkinson's care frequently fails to meet any of these aims 12,21 …”

Az epilepsziás betegek ellátásának változása a COVID–19-járvány első veszélyhelyzeti periódusában

“…Az orvos-beteg találkozások távvizitmegoldásaiban döntő többségben voltak a telefonhívások (100%), ugyanakkor a dokumentáció az esetek egyharmadában nem volt megoldva. A videóhívások száma ebben az időszakban elenyésző volt (6% A krónikus neurológiai betegségek ellátása az egész világon átalakulóban van, részben függetlenül a koronavírus-járványtól [7]. Szakértői vélemények alapján a szakemberhiány és a koronavírus együttes hatásai miatt a távvizitmegoldások előretörése várható [8].…”