Reimagining Parkinson’s healthcare: a patient-focused plan

Special reports

Author: Saskia MairPublished: 3 September 2020

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Is it time to transform healthcare systems? Dr Bastiaan Bloem and Dr Sirwan Darweesh share the motivation behind a new patient-centred model for treating Parkinson’s – and tell us how their care concept could improve the quality of life of people with the condition

“Chronic neurological diseases are the leading source of disability globally. Yet, our healthcare systems are not designed to meet the needs of the many chronic neurological patients,” say Dr Bastiaan Bloem and Dr Sirwan Darweesh.

The two researchers, who work at Radboud University’s Nijmegen Medical Center in the Netherlands, were part of a team that recently outlined a new patient-centered care model that aims to tackle this problem.

The report – published in medical journal The Lancet Neurology – suggests a range of “evidence-based solutions” to address the healthcare challenges facing people with chronic neurological conditions, including Parkinson’s.

“Care is fragmented with poor interdisciplinary collaboration and a lack of timely access to services and therapies,” explain Dr Bloem and Dr Darweesh, reflecting on what motivated the report.

“Furthermore, care is typically reactive. Complex problems are managed inadequately due to a lack of condition-specific expertise and insufficient use of non-pharmacological interventions. Treatment plans tend to focus on the condition rather than the individual living with it and patients are insufficiently involved in clinical decision making.” 

As the world’s fastest growing neurological condition, Parkinson’s was used as a model to explore innovations that could help improve the treatment of different types of movement disorders and chronic neurological conditions.

The future of Parkinson’s treatment?

The team created a model based around eight solutions that offer an integrated approach to treating Parkinson’s, connecting different aspects of healthcare into a “network”.

These solutions include delivering care either in or close to the patient’s home where possible, supporting patient education and self-management, taking a proactive approach to healthcare and using methods like sensors and e-diaries to monitor symptoms and identify problems quickly.

The report encourages a more tailored approach that takes into account individual patient needs, improved access to doctors and specialists, and having “a single point of access” (such as a personal care manager) available to people with Parkinson’s – who can answer basic questions, support referrals and coordinate advice across different healthcare disciplines.

The researchers also highlight the importance of job satisfaction for health workers – and emphasise that it’s crucial to create a work environment that appeals to younger professionals: “This will be critically important in the near future where we have to support an increasing number of elderly patients – with increasingly fewer young people to look after them.”

Putting the model into practise

According to Dr Bloem and Dr Darweesh, the new model could “revolutionise” existing approaches to treating chronic neurological conditions like Parkinson’s.

“The report’s importance lies in creating an integrated set of actions that aim to reduce unnecessary disability for patients, improve quality of life of affected persons and their families and save costs for society ­– helping to keep healthcare affordable for future generations.”

They add that although the full integrated care model may not be easy to implement world-wide, there are opportunities to integrate important elements of it – for example, telemedicine using videoconferencing – into healthcare systems in developing countries.

The team are now putting their ideas to the test at an innovative healthcare project in the Netherlands called PRIME Parkinson, which will give them valuable insights into how the model could work on a larger scale.

“This project will give us hands-on experience with the new model in a ‘living laboratory’ and provide important ‘lessons learned’ for a wider implementation.”

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