More access to specialty care needed
People in Ireland with Parkinson's disease need more access to specialty care and advanced therapies, a a consultant neurologist has said.
Dr Richard Walsh, a neurologist in Dublin's Tallaght Hospital, led a survey-based study to assess issues around disease management and quality of life. The survey included 1,140 people living with Parkinson's, making it one of the largest of its kind ever undertaken in this country.
Parkinson's is a progressive neurological disease, the symptoms of which include tremors, stiffness and slow movement. There is currently no cure. An estimated 9,000 people in Ireland are affected, however this is projected to increase to around 20,000 over the next 20 years as a result of an ageing population.
The survey found that 65% of people with Parkinson's were over 65 years of age. This is the most rapidly growing demographic in the country and is expected to triple in size by 2046, which gives a good indication of the increasing demands that will be placed on health services in the future.
The survey noted that 12% of people with Parkinson's are aged 80 years or older, reflecting improvements in life expectancy.
However, it also revealed that 32% of people with Parkinson's had been admitted to hospital in the previous 12 months and among these, 34% had difficulty getting their medications on time. Almost one in four (23%) felt that their condition had been adversely affected by this.
Meanwhile, 20% of participants admitted to missing a dose of medication at least once a week while at home, and 5% missed a dose every day.
Among those who had been hospitalised, just 17% saw a Parkinson's nurse specialist during their stay, which the researchers believe highlights a missed opportunity to improve medication adherence.
Furthermore, less than half saw a consultant neurologist or geriatrician while in hospital. This, the researchers said, highlights key deficits in levels of specialist staffing in Irish hospitals.
The survey also noted that 29% of people with Parkinson's had experienced a fall in the previous 30 days. Among these, 15% had fallen more than once in that period. Despite the serious heath issues that falls can lead to, such as hip fractures and head injuries, less than half of those said they were being seen by their specialist in an outpatient clinic every six months, which is considered best international practice.
The survey also found that just 3% of people have been treated with deep brain stimulation, which is a surgical approach used to treat advanced Parkinson's disease. Patients must travel to the UK to obtain it as it is not currently available in the Republic of Ireland.
However, the researchers said that if these findings are extrapolated to the whole population, as many as 200 patients currently being treated with oral medication could benefit from deep brain stimulation or other advanced therapies to improve their mobility and quality of life.
Commenting on the findings, Prof Walsh emphasised that Parkinson's is 'not rare and most people will have experience of an affected relative or friend'.
"These results indicate that for some people with Parkinson's disease in Ireland, day-to-day function is adequate and allows a good quality of life. There are some findings however that demonstrate room for improvement, particularly around access to specialty care, hospitalisation and advanced therapies.
"This is going to be of critical importance as we face into the well signposted challenges of a growing elderly population in Ireland and an increased incidence and prevalence of Parkinson's disease," he said.
The study, Treating Parkinson's 2015, was carried out with the assistance of the Parkinson's Association of Ireland and Move4Parkinsons.
http://www.irishhealth.com/article.html?id=25309
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