scholarly journals Personalized Care Management for Persons with Parkinson’s Disease

2020 ◽  
Vol 10 (s1) ◽  
pp. S11-S20
Author(s):  
Angelika D. van Halteren ◽  
Marten Munneke ◽  
Eva Smit ◽  
Sue Thomas ◽  
Bastiaan R. Bloem ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Care Management ◽  
Information Provision ◽  
Care Utilization ◽  
Core Element ◽  
Personalized Care ◽  
Positive Effects ◽  
Management Models ◽  
Core Elements

There is a growing awareness that delivery of integrated and personalized care is necessary to meet the needs of persons living with Parkinson’s disease. In other chronic diseases than Parkinson’s disease, care management models have been deployed to deliver integrated and personalized care, yielding positive effects on patients’ health outcomes, quality of life and health care utilization. However, care management models have been highly heterogeneous, as there is currently no clear operationalization of its core elements. In addition, most care management models are disease-specific and not tailored to the individual needs and preferences of a patient. In this viewpoint we present an integrated and personalized care management model for persons with Parkinson’s disease costing of five core elements: (1) care coordination, (2) patient navigation, (3) information provision, (4) early detection of signs and symptoms through proactive monitoring and (5) process monitoring. Following the description of each core element, implications for implementing the model into practice are discussed. Finally, we provide clinical and methodological considerations on the evaluation of care management models.

scholarly journals Personalized care management for persons with Parkinson's disease: A telenursing solution

2020 ◽  
Vol 3 ◽  
pp. 100070
Author(s):  
Francesca Mancini ◽  
Angelika D. van Halteren ◽  
Tania Carta ◽  
Sue Thomas ◽  
Bastiaan R. Bloem ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Care Management ◽  
Personalized Care

scholarly journals Apomorphine in the treatment of Parkinson's disease: a review

2018 ◽  
Vol 76 (12) ◽  
pp. 840-848 ◽  
Author(s):  
Renata Ramina Pessoa ◽  
Adriana Moro ◽  
Renato Puppi Munhoz ◽  
Hélio A.G. Teive ◽  
Andrew J. Lees
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rescue Therapy ◽  
Continuous Process ◽  
Subcutaneous Administration ◽  
Historical Background ◽  
Infusion Therapy ◽  
Disease Treatment ◽  
Positive Effects

ABSTRACT Optimizing idiopathic Parkinson's disease treatment is a challenging, multifaceted and continuous process with direct impact on patients’ quality of life. The basic tenet of this task entails tailored therapy, allowing for optimal motor function with the fewest adverse effects. Apomorphine, a dopamine agonist used as rescue therapy for patients with motor fluctuations, with potential positive effects on nonmotor symptoms, is the only antiparkinsonian agent whose capacity to control motor symptoms is comparable to that of levodopa. Subcutaneous administration, either as an intermittent injection or as continuous infusion, appears to be the most effective and tolerable route. This review summarizes the historical background, structure, mechanism of action, indications, contraindications and side effects, compares apomorphine infusion therapy with other treatments, such as oral therapy, deep brain stimulation and continuous enteral infusion of levodopa/carbidopa gel, and gives practical instructions on how to initiate treatment.

scholarly journals Transcranial Direct Current Stimulation to Enhance Cognitive Impairment in Parkinson's Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Diana M. A. Suarez-García ◽  
Johan S. Grisales-Cárdenas ◽  
Máximo Zimerman ◽  
Juan F. Cardona
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Cognitive Deficits ◽  
Transcranial Direct Current Stimulation ◽  
Meta Analysis ◽  
Direct Current Stimulation ◽  
Positive Effects ◽  
Cognitive Improvement

Cognitive deficits are increasingly being recognized as a common trait in Parkinson's disease (PD). Recently, transcranial direct current stimulation (tDCS) has been shown to exert positive effects as an adjunctive therapy on motor and non-motor symptoms in PD. This systematic review and meta-analysis aims to provide an overview of reported evidence on the efficacy of tDCS interventions in the treatment of cognitive impairments in PD. A systematic literature review was conducted to examine articles that were published in the past 10 years and that study the effects of tDCS on cognitive deficits in PD patients. The PubMed, Scopus and Scielo databases were searched. Eight tDCS studies involving 168 participants were included for the analysis. Our meta-analysis results showed that anodal tDCS (atDCS) had various levels or no evidence of effectiveness. In the pre-post stimulation analysis, a strong effect was reported for executive functions (pre-post: g = 1.51, Z = 2.41, p = 0.016); non-significant effects were reported for visuospatial skills (pre-post: g = 0.27, Z = 0.69, p = 0.490); attention (pre-post: g = 0.02, Z = 0.08, p = 0.934), memory (pre-post: g = 0.01, Z = 0.03, p = 0.972) and language (pre-post: g = 0.07, Z = 0.21, p = 0.832). However, in the pre-follow-up stimulation analysis, the duration of the effect was not clear. This study highlights the potential effectiveness of atDCS to improve cognitive performance in PD patients but failed to establish a cause-effect relationship between tDCS intervention and cognitive improvement in PD. Future directions and recommendations for methodological improvements are outlined.

scholarly journals Proactive and Integrated Management and Empowerment in Parkinson’s Disease: Designing a New Model of Care

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Emma Tenison ◽  
Agnes Smink ◽  
Sabi Redwood ◽  
Sirwan Darweesh ◽  
Hazel Cottle ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
United Kingdom ◽  
The Netherlands ◽  
Integrated Management ◽  
Models Of Care ◽  
Model Of Care ◽  
New Model ◽  
Positive Effects ◽  
The United Kingdom

Parkinson’s disease is the second most common neurodegenerative condition after Alzheimer’s disease. The number of patients will rise dramatically due to ageing of the population and possibly also due to environmental issues. It is widely recognised that the current models of care for people with Parkinson’s disease or a form of atypical parkinsonism lack continuity, are reactive to problems rather than proactive, and do not adequately support individuals to self-manage. Integrated models of care have been developed for other chronic conditions, with a range of positive effects. A multidisciplinary team of professionals in the United Kingdom and the Netherlands, all with a long history of caring for patients with movement disorders, used knowledge of deficiencies with the current model of care, an understanding of integrated care in chronic disease and the process of logic modelling, to develop a novel approach to the care of patients with Parkinson’s disease. We propose a new model, termed PRIME Parkinson (Proactive and Integrated Management and Empowerment in Parkinson’s Disease), which is designed to manage problems proactively, deliver integrated, multidisciplinary care, and empower patients and their carers. It has five main components: (1) personalised care management, (2) education and empowerment of patients and carers, (3) empowerment of healthcare professionals, (4) a population health approach, and (5) support of the previous four components by patient- and professional-friendly technology. Having mapped the processes required for the success of this initiative, there is now a requirement to assess its effect on health-related and quality of life outcomes as well as determining its cost-effectiveness. In the next phase of the project, we will implement PRIME Parkinson in selected areas of the United Kingdom and the Netherlands.

Phytochemicals as future drugs for Parkinson’s disease: a comprehensive review

2016 ◽  
Vol 27 (6) ◽  
pp. 651-668 ◽  
Author(s):  
Zahra Shahpiri ◽  
Roodabeh Bahramsoltani ◽  
Mohammad Hosein Farzaei ◽  
Fatemeh Farzaei ◽  
Roja Rahimi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Prostaglandin E ◽  
Pharmaceutical Drugs ◽  
Dopamine Depletion ◽  
Therapeutic Approaches ◽  
Positive Effects ◽  
Fatty Acid Amides ◽  
Therapeutic Benefits ◽  
Wide Range

AbstractParkinson’s disease (PD) is the second most common chronic neurodegenerative disease that affects motor skills and cognitive performance. The conventional therapeutic approaches for the management of PD are just able to alleviate symptoms. Exploring for achieving novel substances with therapeutic benefits in PD patients is the focus of a wide range of current investigations. The aim of the present study is to comprehensively review phytochemicals with protective or therapeutic activities in PD and focus on their neuropsychopharmacological mechanisms. Various subgroups of polyphenols (flavonoids, phenolic acids, stilbenes, and lignanes) and terpenes are the most abundant groups of phytochemicals with well-established antiparkinsonian effects. Other phytochemical categories, such as alkaloids, cinnamates, carbohydrates, amino acids, and fatty acid amides, also have some representatives with positive effects in PD. Phytochemicals perform their antiparkinsonian effect through several mechanisms of action, including suppressing apoptosis (via the reduction of Bax/Bcl-2, caspase-3, -8, and -9, and α-synuclein accumulation), decreasing dopaminergic neuronal loss and dopamine depletion, reducing the expression of proinflammatory cytokines (such as prostaglandin E2, interleukin-6, interleukin-1β, and nuclear factor-κB), and modulating nuclear and cellular inflammatory signaling, elevation of neurotrophic factors, and improvement of antioxidant status. Plant-derived natural products can be considered as future pharmaceutical drugs or adjuvant treatment with conventional therapeutic approaches to improve their efficacy and alleviate their psychological adverse effects in the management of PD. Well-designed clinical trials are mandatory to evaluate the protective and healing benefits of phytochemicals as promising future drugs in the management of neurodegenerative diseases.

scholarly journals Disparities in Deep Brain Stimulation Use for Parkinson’s Disease in Ontario, Canada

2020 ◽  
Vol 47 (5) ◽  
pp. 642-655
Author(s):  
James A.G. Crispo ◽  
Melody Lam ◽  
Britney Le ◽  
Lucie Richard ◽  
Salimah Z. Shariff ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Health Care ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Health Care Utilization ◽  
Brain Stimulation ◽  
Conditional Logistic Regression ◽  
Care Utilization ◽  
To Receive ◽  
Deep Brain

ABSTRACT:Objective:To examine whether sociodemographic characteristics and health care utilization are associated with receiving deep brain stimulation (DBS) surgery for Parkinson’s disease (PD) in Ontario, Canada.Methods:Using health administrative data, we identified a cohort of individuals aged 40 years or older diagnosed with incident PD between 1995 and 2009. A case-control study was used to examine whether select factors were associated with DBS for PD. Patients were classified as cases if they underwent DBS surgery at any point 1-year after cohort entry until December 31, 2016. Conditional logistic regression modeling was used to estimate the adjusted odds of DBS surgery for sociodemographic and health care utilization indicators.Results:A total of 46,237 individuals with PD were identified, with 543 (1.2%) receiving DBS surgery. Individuals residing in northern Ontario were more likely than southern patients to receive DBS surgery [adjusted odds ratio (AOR) = 2.23, 95% confidence interval (CI) = 1.15–4.34]; however, regional variations were not observed after accounting for medication use among older adults (AOR = 1.04, 95% CI = 0.26–4.21). Patients living in neighborhoods with the highest concentration of visible minorities were less likely to receive DBS surgery compared to patients living in predominantly white neighborhoods (AOR = 0.27, 95% CI = 0.16–0.46). Regular neurologist care and use of multiple PD medications were positively associated with DBS surgery.Conclusions:Variations in use of DBS may reflect differences in access to care, specialist referral pathways, health-seeking behavior, or need for DBS. Future studies are needed to understand drivers of potential disparities in DBS use.

scholarly journals Progressive Resistance Exercise and Parkinson's Disease: A Review of Potential Mechanisms

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Fabian J. David ◽  
Miriam R. Rafferty ◽  
Julie A. Robichaud ◽  
Janey Prodoehl ◽  
Wendy M. Kohrt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Resistance Exercise ◽  
Cortical Activation ◽  
Future Research ◽  
Healthy Individuals ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Progressive Resistance Exercise ◽  
Progressive Resistance

This paper reviews the therapeutically beneficial effects of progressive resistance exercise (PRE) on Parkinson's disease (PD). First, this paper discusses the rationale for PRE in PD. Within the first section, the review discusses the central mechanisms that underlie bradykinesia and muscle weakness, highlights findings related to the central changes that accompany PRE in healthy individuals, and extends these findings to individuals with PD. It then illustrates the hypothesized positive effects of PRE on nigro-striatal-thalamo-cortical activation and connectivity. Second, it reviews recent findings of the use of PRE in individuals with PD. Finally, knowledge gaps of using PRE on individuals with PD are discussed along with suggestions for future research.

scholarly journals PHYTOCHEMICALS AS FUTURE DRUGS FOR PARKINSON’S DISEASE: A REVIEW

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kamal preetKaur ◽  
Navneet Khurana ◽  
Neha Sharma ◽  
Neha Sharma ◽  
Neha Sharma
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Interleukin 1 ◽  
Neuronal Loss ◽  
Pharmaceutical Drugs ◽  
Dopamine Depletion ◽  
Positive Effects ◽  
Fatty Acid Amides ◽  
Therapeutic Benefits ◽  
Wide Range

Around 1 billion people in the world are suffering from neurological disorders, such as Alzheimer's, Parkinson's, epilepsy, strokes and so other related diseases. Parkinson’s disease (PD) is the second mostcommon chronic neurodegenerative disease that affectsmotor skills and cognitive performance. There have been various conventionaltherapeutic approaches for the management of PD that are justable to alleviate symptoms. In terms of thus Exploring for achieving novelsubstances with therapeutic benefits in PD patients is the focus of a wide range of current investigations. The aim is thus to comprehensively review phytochemicalswith protective or therapeutic activities in PD and hence then focus on their neuropsychopharmacology mechanisms. Various subgroups of polyphenols (flavonoids, phenolic acids, stilbenes, and lignans) and terpenes that are the most abundant groups of phytochemicals with well-established antiparkinsonian effects. Also the Other phytochemical categories, such as carbohydrates, amino acids, alkaloids, cinnamates, and fatty acid amides, also have some representatives with positive effects in PD. Phytochemicalsperform their antiparkinsonian effect through several mechanisms of action, including one is suppressing apoptosis (via the reduction of Bax/Bcl-2, caspase-3, - 8,and -9, and ?-synuclein accumulation), other reducing the expression of proinflammatory cytokines (such as prostaglandin E2, interleukin6, interleukin-1?, and nuclear factor-?B), decreasing dopaminergic neuronal loss and dopamine depletion and modulating nuclear and cellular inflammatory signaling, elevation of neurotrophic factors, and improvement of antioxidant status. The various Plant-derived natural products can be considered as future pharmaceutical drugs or adjuvant treatment with conventional therapeutic approaches to improve their efficacy and attenuate or alleviate their psychological adverse effects in the management of PD.Well-designed recent clinical trials that are manda

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