The diagnostic pathway of Parkinson’s disease: a cross-sectional survey study of factors influencing patient dissatisfaction

Plouvier, Annette O A; Hartman, Tim olde; Bont, Olga A. de; Maandag, Sjoerd; Bloem, Bastiaan R.; Weel, Chris van; Lagro-Janssen, Antoine L. M.

doi:10.1186/s12875-017-0652-y

Cited by 13 publications

(14 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The experience of receiving a diagnosis of Parkinson’s disease (PD) has been reported to have a significant impact on patients’ quality of life even many years after the initial diagnosis [ 1 ]. Several aspects of the diagnostic process, including time to diagnosis, the referral process, how it is reached, the way it is communicated, the information provided and explained, the follow-up actions planned and the treatments started are all likely to be factors that can influence the impact of the diagnosis [ 2 ]. However, how the diagnostic process is experienced from the patient’s point of view and which factors influence their experience of the diagnostic process have received little attention.…”

Section: Introductionmentioning

confidence: 99%

Patient experiences of receiving a diagnosis of Parkinson’s disease

et al. 2018

View full text Add to dashboard Cite

ObjectiveTo report patients’ own experiences of receiving a diagnosis of Parkinson’s disease (PD) and to identify factors influencing this experience.MethodsA survey by the European Parkinson’s Disease Association in 11 European countries.Results1775 patients with an average age of 69.7 years participated of whom 54% were male. Those living in rural areas reported having waited longer to seek medical help (p < 0.05). A possible diagnosis of PD was made at the first appointment in a third of respondents. When the diagnosis was made, only 50% reported that the diagnosis was communicated sensitively. 38% of patients reported having been given enough time to ask questions and discuss concerns, but 29% did not. 98% of participants reported having been given information about PD at the time of diagnosis but 36% did not find the information given helpful. Patient satisfaction with the diagnostic consultation was positively associated with more sensitive delivery of diagnosis, the helpfulness and quantity of the information provided and time to ask questions (all p < 0.001). Where diagnosis was given by a specialist, participants reported greater perceived satisfaction with the diagnostic consultation, greater sensitivity of communicating the diagnosis, time to ask questions, provision and helpfulness of information, and earlier medication prescription (all p < 0.0001).ConclusionsThere is a need to improve how the diagnosis of PD is communicated to patients, the opportunity to ask questions soon after diagnosis, and the amount, timing and quality of life information provided, as this is associated with greater satisfaction with the diagnostic process.Electronic supplementary materialThe online version of this article (10.1007/s00415-018-8817-8) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Patient experiences of receiving a diagnosis of Parkinson’s disease

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Geriatricians spent more time in consult with PD patients compared with GPs (median [Q1-Q3] = 20 [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] vs 10 [10-15] minutes, p < 0.001). Geriatricians were more comfortable initiating PD medications than GPs (OR = 11.8 [95% CI: 3.54-39.3], p < 0.001), independent of gender, years of practice and duration of consult.…”

Section: Resultsmentioning

confidence: 99%

“…Geriatricians spent longer time in consults with PD patients than GPs (median [Q1-Q3] = 20 min [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] vs 10 min [10][11][12][13][14][15], p < 0.001). Table 1 summarizes the questionnaire responses according to the medical specialty of the respondents.…”

Section: General Respondent Characteristicsmentioning

confidence: 99%

“…In Singapore, geriatricians are seen as specialists, and hence may not encounter patients that request for a specialist (neurologist) confirmation of the PD diagnosis as frequently as GPs. This insistence on a specialist review before initiation of treatment may lead to significant delay in care and adverse outcomes for the patient [18,19].…”

Section: Confidence and Comfort In Pd Carementioning

confidence: 99%

See 1 more Smart Citation

A cross-sectional study of knowledge and practices in the management of patients with Parkinson’s disease amongst public practice-based general practitioners and geriatricians

Lim

Saffari

Neo

2022

BMC Health Serv Res

View full text Add to dashboard Cite

Background As most patients are likely to first interface with their community general practitioner (GP) or geriatrician for chronic healthcare conditions, these non-neurologists practitioners are well-placed to diagnose, initiate treatment in symptomatic Parkinson’s disease (PD) patients, and provide regular and timely management of their PD. However, current studies suggest that the role of the GP and geriatrician in providing holistic care for PD patients may be limited by factors such as patient perceptions, and a lack of knowledge base in the quality measures of care. This paper aims to better understand the different management styles between GPs and geriatricians practicing in public institutions in Singapore, qualify the difficulties they face in providing patient-centric care for PD patients, and identify any gaps in quality measures of care. Methods A questionnaire was completed anonymously by GPs (n = 43) and geriatricians (n = 33) based at public institutions, on a voluntary basis before a compulsory didactic teaching on PD. Questions were modelled after quality measures set out by the American Academy of Neurology, specifically eliciting information on falls, non-motor symptoms, exercise regime and medication-related symptoms. “PD management practices and styles” questions were answered by the respondents on a 4-point Likert scale. Results Geriatricians spent more time in consult with PD patients compared with GPs (median [Q1-Q3] = 20 [15–30] vs 10 [10–15] minutes, p < 0.001). Geriatricians were more comfortable initiating PD medications than GPs (OR = 11.8 [95% CI: 3.54–39.3], p < 0.001), independent of gender, years of practice and duration of consult. Comfort in initiating dopamine replacement therapy (OR 1.06 [1.00–1.36], p = 0.07; aOR = 1.14 [1.02–1.26], p = 0.02) also increased with physician’s years of practice. Unfamiliarity with the types and/or doses of the medications was the most cited barrier faced by GPs (76.7%). Geriatricians were more likely than GPs to ask about falls (100% vs 86.0%, p = 0.025), non-motor symptoms (75.8% vs 53.5%, p = 0.049) and the patient’s regular physical activities (72.7% vs 41.9%, p = 0.01). Conclusions This study identified key patterns in the management practices and styles of non-neurologists physicians, and identified gaps in current practice. Our data suggests that interventions directed at education on PD medication prescriptions and provision of patient PD education, creation of best clinical practice guidelines, and accreditation by national bodies may instil greater confidence in practitioners to initiate and continue patient-centric PD care. A longer consultation duration with PD patients should be considered to allow physicians to get a greater scope of the patient’s needs and better manage them.

show abstract

“…8 Perceived diagnostic delay and the involvement of more than one additional healthcare provider have been associated with patient dissatisfaction in the diagnostic process. 9 In contrast, patient satisfaction has been strongly associated with more sensitive delivery of the diagnosis, the helpfulness of the information provided and whether an opportunity to ask questions was provided. 10 Allowing patients the space for questions and expressions of anxiety can be crucial in their overall experience of the diagnostic process.…”

Section: Delivering the Diagnosismentioning

confidence: 99%