Impact of medical care quality on the course of Parkinson’s disease

2020 ◽  
Vol 18 (5) ◽  
pp. 124-130
Author(s):  
S. V. SHTAIMETS ◽  
◽  
N. G. ZHUKOVA ◽  
I. A. ZHUKOVA ◽  
D. A. NOVOTNYY ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Medical Care ◽  
Clinical Medicine ◽  
Care Quality ◽  
Clinical Recommendations ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
The Impact

Standardization of medical and diagnostic care is one of the most urgent problems of modern clinical medicine. However, whether the course of Parkinson’s disease (PD) depends on compliance or deviation from the established regulations remains unclear. The purpose. To evaluate the effectiveness of medical care provided to patients with PD in accordance with the standard and clinical recommendations, in comparison with patients who were treated with violations; to study the impact on the course and progression of the disease of non-compliance with certain provisions of the standard and clinical recommendations. Material and methods. The analysis of 7264 examinations of the quality of medical care of 1754 patients with PD during 60 months was carried out. Results. Defects in the provision of medical care that affected the progression of the disease, as well as the formation of social and household maladaptation (disability) were identified. There were deviations from the standards in the management of patients which did not have a significant impact on PD. Conclusions. Medical care provided according to the standards of management of PD patients approved in the Russian Federation does not affect the course of the disease, but helps to postpone the period of disability. With a high confidence level, the disease progression and reduction of the degree of social and professional adaptation are influenced by the defects in complaints and anamnesis collection, as well as not timely administration of medicaments containing levodopa, against the background of, most likely, non-compliance with all clinical recommendations and standards for PD patients.

scholarly journals THE LEGISLATIVE FOUNDATION OF EXPERTISE OF MEDICAL CARE QUALITY ACCORDING CASES OF LETHAL OUTCOMES

2019 ◽  
Vol 62 (2) ◽  
pp. 95-102
Author(s):  
Konstantin V. Polyakov ◽  
N. M. Gayfullin ◽  
Zh. A. Akopyan ◽  
P. G. Mal'kov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Quality Evaluation ◽  
Evaluation Criteria ◽  
Care Quality ◽  
Icd 10 ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Care Support

The article presents analysis of national and foreign legislative documents concerning issues of expertise of quality of medical care according cases of lethal outcomes (Universal Declaration of Human Rights, the Constitution of the Russian Federation, ICD-10, Federal laws and sectoral orders). It is established that key elements of system of medical care quality control (levels of control, authorized authority, forms of control, sources of development of criteria of quality evaluation, criteria of quality evaluation) are determined legislatively and reflect main requirements of international documents. The criteria of medical care quality evaluation are developed by groups of diseases of conditions on the basis of corresponding of medical care support Procedures, medical care Standards, Rules of implementation of laboratory, instrumental, pathologico-anatomic and other forms diagnostic analysis and Clinical Recommendations (records of treatment) related to issues of medical care support. The shortcoming of the Russian Federation legislation is an inadequate reflection of sources of development of criteria of medical care quality evaluation and relevant incompleteness of the very criteria of medical care quality evaluation. Therefore, their application by experts to issues of evaluation of medical care quality is complicated that effects formation of expert conclusion and negatively affects detection and prevention of possible violations during medical care support. The outdated normative regulation of clinical pathologic anatomic conference is noted as an important form of control of medical care support according cases of lethal outcomes. The necessity of alterations and additions in particular currently in force documents concerning issues of expertise of medical care quality, including according cases of lethal outcomes.

The impact of sleep and mood disorders on quality of life in Parkinson’s disease patients

2011 ◽  
Vol 258 (12) ◽  
pp. 2222-2229 ◽  
Author(s):  
Eva Havlikova ◽  
Jitse P. van Dijk ◽  
Iveta Nagyova ◽  
Jaroslav Rosenberger ◽  
Berrie Middel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mood Disorders ◽  
The Impact

Motor Symptom Asymmetry Predicts Non-motor Outcome and Quality of Life Following STN DBS in Parkinson's Disease

2021 ◽  
Author(s):  
Julie Péron ◽  
Philippe Voruz ◽  
Jordan Pierce ◽  
Kévin Ahrweiller ◽  
Claire Haegelen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Symptom ◽  
Control Group ◽  
Motor Symptoms ◽  
Healthy Control ◽  
The Impact ◽  
Stn Dbs

Abstract Risk factors for long-term non-motor disorders and quality of life following subthalamic nucleus deep-brain stimulation (STN DBS) have not yet been fully identified. In the present study, we investigated the impact of motor symptom asymmetry in Parkinson’s disease.Data were extracted for 52 patients with Parkinson’s disease (half with left-sided motor symptoms and half with right-sided ones) who underwent bilateral STN and a matched healthy control group. Performances for cognitive tests and neuropsychiatric and quality-of-life questionnaires at 12 months post-DBS were compared with a pre-DBS baseline. Results indicated a deterioration in cognitive performance post-DBS in patients with left-sided motor symptoms. Performances of patients with right-sided motor symptoms were maintained, except for a verbal executive task. These differential effects had an impact on patients’ quality of life. The results highlight the existence of two distinct cognitive profiles of Parkinson’s disease, depending on motor symptom asymmetry. This asymmetry is a potential risk factor for non-motor adverse effects following STN DBS.

scholarly journals The impact of cognitive performance on quality of life in individuals with Parkinson's disease

2016 ◽  
Vol 10 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Maira Rozenfeld Olchik ◽  
Annelise Ayres ◽  
Marcieli Ghisi ◽  
Artur Francisco Schumacher Schuh ◽  
Carlos Roberto Mello Rieder
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Poor Performance ◽  
Cognitive Testing ◽  
Cognitive Tests ◽  
Patient Consent ◽  
The Impact

ABSTRACT Background: Evidence points to the occurrence of cognitive impairment in all stages of PD, constituting a frequent and debilitating symptom, due to high impact on quality of life and mortality of patients. Objective: To correlate cognitive performance with quality of life in PD. Methods: The sample was drawn from a Movement Disorders Clinic of a reference hospital in Porto Alegre. Inclusion criteria were: PD diagnosis, according to the United Kingdom Parkinson's Disease Society Brain Bank criteria for idiopathic PD (Hughes et al. 1992) and patient consent to participate. Patients with other neurological pathologies and those submitted to deep brain stimulation were excluded. The evaluation consisted of a cognitive testing battery (composed of eight tests for assessing cognitive performance), and a questionnaire on quality of life (PDQ-39) and depression (BDI). Results: The sample comprised 85 individuals with PD, with a mean age of 62.9 years (±10.7), mean disease duration of 10.4 years (±5.7), and mean educational level of four years (±4.3). There was a significant relationship between total score on the PDQ and all cognitive tests, showing that poor cognitive performance was correlated with poor quality of life. Moreover, a significant correlation was observed between cognitive tests and depression, H&Y, education level, and age. Conclusion: It may be concluded that the individuals with PD in this sample showed a correlation between poorer quality of life and worse cognitive performance. Poor performance was also correlated with more advanced stage, older age, low level of education and depression.

scholarly journals B-23 Non-Motor Symptom Profile in Parkinson’s Disease Patients and its impact on Quality of Life

2019 ◽  
Vol 34 (6) ◽  
pp. 969-969
Author(s):  
L Sabbah-Talasazan ◽  
J Miller ◽  
J Wertheimer
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disturbance ◽  
Motor Symptom ◽  
Age Cohorts ◽  
Cognitive Difficulties ◽  
Symptom Profile ◽  
The Impact

Abstract Objective Non-motor Symptoms (NMS) in Parkinson’s Disease (PD) are known to be diverse and may include cognitive, psychiatric and sleep disturbance, fatigue, and autonomic disorders (e.g., cardiovascular dysregulation, orthostatic hypotension, thermo-dysregulation, sexual dysfunction, urinary and bowel dyscontrol). The aim of this study was to define the NMS profile in a large sample of PD patients with and without Deep Brain Stimulation (DBS) and its impact on quality of life (QOL). Method Cross-sectional, survey-based research design was used. 1,164 individuals with PD participated in this survey: 275 participants who underwent DBS and 889 without DBS. Participants completed the Non-Motor Symptom Scale (NMSS) and answered questions assessing the impact of NMS on everyday life. Participants were divided into younger (ages 50-69) and older (ages 70+) age cohorts and disease duration cohorts with early stage ( < 6 years) and advanced stage (6-10 years; 11+ years) groups. Results 24 out of 31 NMS categories were experienced by more than 50% of the participants. Urination difficulty, fatigue, sleep, constipation, and cognitive difficulties were symptoms most frequently reported to adversely impact day-to-day living, and cognitive difficulties followed by sleep disturbance had the strongest impact to quality of life. Conclusions NMS burden drives quality of life for many individuals and has remained a relatively new frontier for exploration, at least in depth and scope as it relates to assessment and treatment of NMS. Management of NMS remains an unmet need for individuals with PD. Implications for neuropsychologists are discussed.

scholarly journals The Impact of Mind-Body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 17 (1) ◽  
pp. 31 ◽  
Author(s):  
Xiaohu Jin ◽  
Lin Wang ◽  
Shijie Liu ◽  
Lin Zhu ◽  
Paul Dinneen Loprinzi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Depressive Symptoms ◽  
Motor Function ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Cochrane Library ◽  
The Impact

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson’s patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = −0.61, p < 0.001), TUG (SMD = −1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = −1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I2 = 81%) and depression (I2 = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG (I2 = 29%), Balance (I2 = 16%) and QoL (I2 = 35%), it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson’s disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

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