Practical approaches to commencing device-assisted therapies for Parkinson's disease in Australia

Williams, David R., Evans, Andrew H., Fung, Victor S. C., Hayes, Michael, Iansek, Robert, Kimber, Thomas, O'Sullivan, John D. and Sue, Carolyn M. (2017) Practical approaches to commencing device-assisted therapies for Parkinson's disease in Australia. Internal Medicine Journal, 47 10: 1107-1113. doi:10.1111/imj.13398


Author Williams, David R.
Evans, Andrew H.
Fung, Victor S. C.
Hayes, Michael
Iansek, Robert
Kimber, Thomas
O'Sullivan, John D.
Sue, Carolyn M.
Title Practical approaches to commencing device-assisted therapies for Parkinson's disease in Australia
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
1445-5994
Publication date 2017-10-01
Year available 2017
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/imj.13398
Open Access Status Not yet assessed
Volume 47
Issue 10
Start page 1107
End page 1113
Total pages 7
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Abstract In Australia 1% of individuals aged over 50 years have Parkinson disease (PD). Guidance for commencing device-assisted therapies (DAT) for PD in Australia was developed based on a review of European recommendations and their relevance to the local clinical setting. An online survey and teleconference discussions were held by a group of eight local movement disorder experts to develop consensus. Referral to a movement disorder specialist and consideration of DAT is appropriate when motor fluctuations cause disability or reduced quality of life, response to treatment is inconsistent or motor fluctuations and dyskinesias require frequent treatment adjustment without apparent benefit and levodopa is required four or more times daily. Three types of DAT are available in Australia for patients with PD: continuous subcutaneous apomorphine; continuous levodopa-carbidopa intestinal gel infusion; and deep brain stimulation. All improve consistency of motor response. The most important aspects when considering which DAT to use are the preferences of the patient and their carers, patient comorbidities, age, cognitive function and neuropsychiatric status. Patients and their families need to be provided with treatment options that are suitable to them, with adequate explanations regarding the recommendations and comparison of potential device-related complications. DAT are best managed, where possible, in a specialist centre with experience in all three types of therapy. Proactive and early management of symptoms during disease progression is essential to maintain optimally motor responses and quality of life in patients with PD.
Keyword Parkinson’s Disease
Dyskinesias
Carbidopa, levodopa drug combination
Apomorphine
Deep brain stimulation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
School of Medicine Publications
 
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Created: Mon, 18 Sep 2017, 10:17:14 EST by John O'Sullivan on behalf of UQ Centre for Clinical Research