Patient education in Parkinson's disease: Formative evaluation of a standardized programme in seven European countries

Macht, Michael; Gerlich, C.; Ellgring, Heiner; Schradi, Martina; Rusiñol, Àngels Bayés; Crespo, Maricruz; Prats, Anna; Viemerö, Vappu; Lankinen, Anu; Bitti, Pio Enrico Ricci; Candini, Lorena; Spliethoff-Kamminga, N. G. A.; Vreugd, Janny de; Simons, Gwenda; Pasqualini, Marcia Smith; Thompson, Simon B. N.; Taba, Pille; Krikmann, Ülle; Kanarik, Eve

doi:10.1016/j.pec.2006.08.005

Cited by 70 publications

(77 citation statements)

References 27 publications

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“…The content was the same for patients and carers and included psychoeducation sessions, as well as core CBT modules such as relaxation training, cognitive restructuring and situational behaviour analysis. The final sample consisted of 137 carers (they were not selected on the basis of psychological need) and 151 patients 42 43. The studies found that the intervention was associated with high degree of acceptability to carers and patients and there was improvement in the psychosocial burden experienced by both groups.…”

Section: Resultsmentioning

confidence: 99%

Cognitive–behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review

Koychev

Okai

2017

Evid Based Mental Health

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Neuropsychiatric symptoms are common in Parkinson's disease (PD) and have a disproportionate impact on quality of life and carer burden. Pharmacological treatment is the main approach in dealing with these symptoms, but it is limited by variable efficacy and risk of drug interactions. Non-pharmacological approaches using the cognitive-behavioural therapy (CBT) model are viable alternatives and in this review paper we summarise the evidence of CBT for three of the most common psychiatric manifestations of PD: depression and anxiety, impulse-control disorders and insomnia. Most studies modified the usual CBT format to include modules accounting for problems specific to PD: activity scheduling around motoric function, motor symptoms as triggers of anxiety, fear of falling and preparation for disease progression as well as accommodation of materials for suspected executive dysfunction. We found a growing evidence base that CBT (modified to account for PD-specific problems) is effective in the treatment of PD psychiatric symptoms. Where controlled study design was used, moderate effect sizes are reported for the efficacy of CBT for depression, including with distance administration of CBT. The effects were sustained during follow-up which was between 1 and 6 months. In addition, there are some initial data on the effects of CBT on impulse-control disorders and insomnia. The studies were limited by their small and potentially unrepresentative samples and the quality of sample reporting (eg, concomitant antidepressant and dopaminergic therapy use). Additional welldesigned and adequately powered studies are required to determine the utility of CBT in PD. INTRODUCTIONParkinson's disease (PD) is classically defined by a triad of motor symptoms (tremor, rigidity and bradykinesia). It is, however, increasingly conceptualised as a neuropsychiatric disorder 1 in view of the high prevalence of psychiatric features, including depression, impulse control disorders (ICD) and sleep difficulties.2 These non-motor complications are better predictors of disability, distress and rates to institutionalisation than the motor symptoms.3 Of the non-motor complications, mixed depression and anxiety is the most common psychiatric comorbidity, affecting ∼50% of PD patients, significantly more common that rates in the general population.4 Depression and anxiety are the strongest predictors of poorer quality of life, 5 even in the advanced stages of the illness where the motor features have progressed fully.6 ICD are characterised by repetitive, reward-based behaviours, linked to the dopaminergic medication used to treat the motor symptoms. They affect ∼14% of all PD patients 7 and are associated with psychiatric comorbidity and high carer burden.8 Sleep disturbance is another neuropsychiatric symptom that affects up to 60% of all PD patients.9 It is associated with somnolence 10 and impairment in attention and executive function.11 On the basis of their impact on quality of life and outcome, the recognition and treatment of neuropsych...

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Section: Resultsmentioning

confidence: 99%

Cognitive–behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review

Koychev

Okai

2017

Evid Based Mental Health

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“…The EduPark patient education programme for people with Parkinson's Disease and their carers aimed to deal with psychosocial problems and an initial UK evaluation (Simons et al 2006) found short-term positive effects on mood and favourable evaluation by participants; however no significant effects were found with regards to quality of life and depression. EduPark was also tested across seven E.U countries using purely Parkinson's Disease patients; again this found short-term mood elevation but also reduced disease-related psychosocial problems long-term (Macht et al 2007). Therefore the EduPark appears to be an intervention that broadens patients' knowledge and establishes skills essential for self-management of Parkinson's Disease by addressing emotional and social problems and promoting activities to help deal with these condition-specific issues.…”

Section: Background: Overview On Evidence Of Self-management Intervenmentioning

confidence: 96%

Self-management for people with long-term neurological conditions

Chaplin

Hazan

Wilson

2012

Br J Community Nurs

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Although English government policy has encouraged the implementation of self-management programmes in services for people with long term conditions, the evidence for their efficacy has been limited. People with long term neurological conditions utilise community based health services including community nursing, and have particular needs in regards to self-management. This article provides an overview of the evidence of the effectiveness of self-management interventions for people with long term neurological conditions, in particular those with stroke, Parkinson's Disease and Multiple Sclerosis. The current need for better interventions is highlighted, particularly the importance of providing condition-specific information and deliverance of interventions in a group setting to improve self-management outcomes. In response to previous weaknesses of selfmanagement interventions for this population, an innovative Hertfordshire Neurological Service selfmanagement programme is discussed with implications for future research described.

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“…This can result in loss of confidence and independence (Mao et al, 2013). Self-help education programmes develop selfregulation skills through activities that include stress management, dealing with depression or anxiety and maintaining social competence (Macht et al, 2007;A'Campo et al, 2010).…”

Section: Education and Supportmentioning

confidence: 99%

Management of levodopa for residents with Parkinson’s disease

Mages

2016

Nursing Older People

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SummaryThis article discusses the medication management of levodopa in older people who have Parkinson's and live in a nursing home setting. It provides a detailed description of the diagnostic criteria, motor and non-motor clinical features of Parkinson's disease. Against this clinical picture the benefits and challenges of levodopa medication management are considered. A person-centered approach is championed as it supports collaborative clinical assessment and decision making between nurses and residents. To fully appreciate why a person-centered approach is important to safe and effective medication practice the pharmacological basis of levodopa management is explained. An empowerment approach to medication management is advocated that facilitates self-medication by residents. To this end the importance of continuous professional development for nursing home staff is discussed.

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Patient education in Parkinson's disease: Formative evaluation of a standardized programme in seven European countries

Cited by 70 publications

References 27 publications

Cognitive–behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review

Cognitive–behavioural therapy for non-motor symptoms of Parkinson's disease: a clinical review

Self-management for people with long-term neurological conditions

Management of levodopa for residents with Parkinson’s disease

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