Abstract

BACKGROUND

A multidisciplinary (MDT) approach is increasingly recommended as the standard of care for patients with Parkinson’s disease (PD). Research has shown that an MDT approach can lead to better quality of life and improve patient outcomes in a number of domains depending on set up. We established an MDT clinic with a PD specialist physiotherapist and pharmacist to assess how this would improve patient outcomes at a DGH hospital.

METHOD

An MDT clinic led by a consultant geriatrician with a PD specialist pharmacist and a physiotherapist that could assess patients attending the clinic was established once weekly. This run alongside a pre-existing weekly PD clinic with only a consultant geriatrician. We analysed data from both clinics at one year and compared the outcomes regarding:- access to physiotherapy, rates of de-prescribing and medication side effects monitoring, and rates of falls and hospital attendances at six months and one year.

RESULTS

Overall, the results of the project were positive despite a smaller sample size than anticipated due to the covid pandemic. The results showed the presence of a physiotherapist in clinic not only leads to earlier access to physiotherapy, but may also lower the clinician threshold for referral leading to earlier identification of patients at risk. The results also showed a benefit to having a pharmacist in clinic especially in increasing the rates of documented side effect monitoring. Importantly, a chi-squared analysis showed a statistically significant reduction in the number of patients from the MDT clinic having a hospital attendance between 6-12 months. There were also smaller reductions in falls and hospital attendances across both time periods for patients in the MDT clinic. Further cycles are needed to solidify these associations and to analyse the mechanisms by which the effects especially the reduced attendance rates at 6-12 months occur.