Patterns and predictors of referrals to allied health services for individuals with Parkinson's disease: A Parkinson's foundation (PF) QII study

Investigators, PF Qii Principal

doi:10.1016/j.parkreldis.2020.11.024

Cited by 21 publications

(21 citation statements)

References 30 publications

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“…Improving reach, adoption, and effectiveness of OT for PwEP are opportunities for clinical and research improvement. We found OT to be the least common area of rehabilitation, which aligns with data from larger patient registries [8]. Similar to Roberts and colleagues, we found that OT was initiated most frequently in the context of multidisciplinary rehabilitation rather than a solo entry point into the rehabilitation system [8].…”

Section: Discussionsupporting

confidence: 88%

“…We found OT to be the least common area of rehabilitation, which aligns with data from larger patient registries [8]. Similar to Roberts and colleagues, we found that OT was initiated most frequently in the context of multidisciplinary rehabilitation rather than a solo entry point into the rehabilitation system [8]. We also found that follow-up visits were rare within the first year, despite the documented impairments supporting the need for OT.…”

Section: Discussionsupporting

confidence: 87%

“…Clinical practice guidelines (CPG) recommend occupational therapy (OT) services for people with PD in all stages of the disease [3][4][5]. Yet, data reveals that people with PD rarely use OT [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Occupational Therapy for People with Early Parkinson’s Disease: A Retrospective Program Evaluation

Sadural

MacDonald

Johnson³

et al. 2022

Parkinson's Disease

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Purpose. Clinical practice guidelines establish that occupational therapy (OT) services are indicated for people with early Parkinson’s disease (PD). However, OT is uncommon compared to other rehabilitation services. This study describes the development and evaluation of a proactive, consultative OT program for people with early PD as a part of an integrated care approach. Materials and Methods. The program was developed by an occupational therapist adapting practice guidelines for people with early PD. Retrospective program evaluation occurred at an outpatient rehabilitation clinic. The consultative OT program for early PD includes a 90-minute evaluation with instruction in self-management techniques, individually tailored exercises, and follow-up recommendations. The program was evaluated with the RE-AIM framework. Postprogram semistructured interviews provided patient-reported program effectiveness and satisfaction. Results. In 2018, 23 individuals used OT out of 77 people with early PD who attended the proactive rehabilitation program. Most individuals (n = 16, 69.6%) were within Hoehn and Yahr stages 1-2 and were seen within 3 years of PD diagnosis. Participants presented with deficits in hand strength (60.0 ± 23.4 pounds) and dexterity (right hand 30.0 ± 8.0 seconds) and reported complaints about basic and/or instrumental activities of daily living (n = 15, 65.2%). Semistructured interviews (n = 16) revealed that most individuals (75%) reported high satisfaction. Of the 10 who recalled a home exercise program, 60% reported continued adherence. Consultative OT was delivered with fidelity in 22/23 individuals (96%). After one year, only two occupational therapists at one clinic had adopted the program, and the program is maintained in the organization. Conclusion. Occupational therapists reached people in the early stages of PD when a specific program was tailored to evaluate and target their specific needs. Motor activity deficits noted in individuals with early PD support future scaling and sustainability efforts of OT within this population. Quality improvement suggestions are discussed for future implementation and clinical trials.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

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Occupational Therapy for People with Early Parkinson’s Disease: A Retrospective Program Evaluation

Sadural

MacDonald

Johnson³

et al. 2022

Parkinson's Disease

Self Cite

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“… 48 Some countries with advanced economies have more robust long-term care insurance systems and better rehabilitation facilities where PwPDs have early and ongoing access to rehabilitation services. 49 However, in the face of the shortage of rehabilitation resources and the unreachable status of continuous services in China, we suggest developing scientific and effective strategies for exercise intervention through multidisciplinary team cooperation for inpatients and outpatients. Meanwhile, HcPs should change the concept of home exercise for PwPDs, realise the importance of early rehabilitation authorisation, and improve the patients' ability and readiness for home exercise.…”

Section: Discussionmentioning

confidence: 99%

Barriers to home exercise for patients with Parkinson’s disease: a qualitative study

Wang

et al. 2023

BMJ Open

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ObjectiveThis study aimed to explore the barriers to home exercise for patients with Parkinson’s disease (PwPDs) and to provide guidelines for healthcare providers to build and implement home exercise strategies for PwPDs.DesignA qualitative descriptive method was used. Semistructured interviews were conducted and thematic analysis was employed.SettingThe study was conducted at the Department of Neurology at a grade 3 Class A general hospital in China.ParticipantsA total of 24 participants were interviewed, including 10 PwPDs, 7 caregivers, 4 nurses, 1head nurse, and 2 Parkinson’s clinicians.ResultsFive themes were identified in this analysis. (1) Psychosomatic stress and low activity; (2) Lack of early rehabilitation authorisation; (3) Poor ‘flow’ state of home exercise; (4) iInaccessibility of continued service; (5) Sociocultural impact on family coping.ConclusionPwPDs, caregivers and specialised medical staff raised the challenges faced by patients' home exercises from different perspectives. We can improve services and integrate resources through the management of multi-disciplinary, early rehabilitation authorisation, exercise experience, continuous service mode, and family coping strategies under different cultures to gradually adjust the home exercise behaviour of PwPDs.

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“…The NICE guideline of the United Kingdom, published in 2017, recommended considering early referral of PD patients to experienced physiotherapists, occupational therapists, and speech and language therapists [ 11 ]. Recently, an international multicenter prospective study demonstrated that the rehabilitation referral rates at expert care centers for PD were, on average, 34.7% at 4 sites in Canada, 35.3% at 17 sites in the United States, 25.2% at a site in Israel (Tel Aviv Sourasky Medical Center), and 66.7% at a site in the Netherlands (Radboud University Nijmegen Medical Center) [ 37 ]. These results suggest that European countries have provided more adequate rehabilitation therapy for PD patients than other countries.…”

Section: Rehabilitation Usagementioning

confidence: 99%

Changes in Epidemiological Trends and Rehabilitation Usage in Neurological Diseases in Korea: Parkinson's Disease

Yun

Seo

2021

Brain Neurorehabil

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Parkinson's disease (PD) is a neurodegenerative disorder characterized by typical motor symptoms such as resting tremor, bradykinesia, and rigidity, as well as non-motor manifestations, including psychiatric symptoms, autonomic dysfunction, and cognitive impairment. These symptoms induce a marked impact on functional independence in daily activities and quality of life in PD patients. Recent guidelines recommend adequate rehabilitation education and treatment from the early stages of PD, and rehabilitation has become part of standard care for PD. In Korea, the number of patients with PD has more than tripled over 15 years, from 39,265 in 2004 to 125,607 in 2019. However, the rehabilitation usage of PD patients has not changed remarkably, and it remains suboptimal in Korea compared to several developed countries, which have advanced and disseminated guidelines and implemented specialized care delivery systems for PD over the past 20 years. Additional efforts are warranted to provide adequate rehabilitation therapies for PD patients in Korea.

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Patterns and predictors of referrals to allied health services for individuals with Parkinson's disease: A Parkinson's foundation (PF) QII study

Cited by 21 publications

References 30 publications

Occupational Therapy for People with Early Parkinson’s Disease: A Retrospective Program Evaluation

Occupational Therapy for People with Early Parkinson’s Disease: A Retrospective Program Evaluation

Barriers to home exercise for patients with Parkinson’s disease: a qualitative study

Changes in Epidemiological Trends and Rehabilitation Usage in Neurological Diseases in Korea: Parkinson's Disease

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