The Management of Parkinson's Disease in the Primary Care Setting
A supplement to Internal Medicine News.
This supplement was supported by an educational grant from TEVA Neuroscience and jointly sponsored by Duke School of Medicine and TCL Institute.
Burton L. Scott, MD, PhD
Co-Activity Director
Associate Clinical Professor of Medicine
Department of Neurology
Duke University Medical Center
Durham, North Carolina Dr. Scott has nothing to disclose.
Mark A. Stacy, MD
Co-Activity Director
Associate Professor of Clinical Medicine
Department of Neurology
Duke University Medical Center
Durham, North Carolina Dr. Stacy reported that he is an advisory board member for Allergan, Inc.; Endo Pharmaceuticals Inc.; General Electric Company; GlaxoSmithKline; and Osmotica Pharmaceutical Corp. He also reported that he is a speaker for Boehringer Ingelheim Corporation, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Teva Neuroscience, Inc., and Vernalis plc; a consultant to Boehringer Ingelheim Corporation, Novartis Pharmaceuticals Corporation, and Vernalis plc; a peer reviewer for Kyowa Hakko USA; an independent contractor for General Electric Company; and a panel member for Medtronic, Inc.
Topic Highlights
• Early Diagnosis of PD
• Prevalence, Impact, and Epidemiology of PD
• Pathogenesis
• Nonmotor Features of PD
• Differential Diagnosis
• Clinical Diagnosis
• Detecting Motor Features of PD
• Rating Scales to Aid PCP-Patient
• Comunication and Assess Disease
• Progression
• Treatment of PD
• Summary
Statement of Need
Parkinson's disease (PD) is chronic, progressive, and poses numerous challenges for health care providers. Future projections estimate the worldwide number of confirmed PD patients could climb to 9.3 million by 2030, a number which does not include individuals who have acquired PD without knowing it and are not receiving treatment.
Although PD can be managed, current pharmacotherapies only control symptoms. Since there is no cure, early detection and diagnosis of PD are critical. Primary care clinicians-typically the first health care provider a patient sees-will be expected to identify the initial, subtle nonmotor symptoms of PD, which may precede obvious motor symptoms by years. And, in today's managed care model, primary care clinicians oversee multiple aspects of a patient's health care needs, from differentiating PD from other forms of parkinsonism, administering medications, working with neurologists, and monitoring disease progress.
Primary care clinicians need to be aware of current pharmacotherapies, adverse events associated with these medications, and when PD patients should be referred to neurologists. Ongoing education in diagnosis and treatment strategies of PD is needed for PCPs to optimally manage their PD patients' health problems that are both related and unrelated to PD throughout the course of the disease.
This monograph will provide information for primary care clinicians on the diagnosis and management of patients with PD, including established treatment guidelines and pharmacologic options for use in everyday clinical practice.
Target Audience
This activity is designed for primary care physicians, physician assistants, nurses, pharmacists, and nurse practitioners who treat Parkinson's disease.
Learning Objectives
At the conclusion of the program, participants should be able to:
• Identify the cardinal symptoms of Parkinson's disease and differentiate it from other movement disorders
• Compare the primary pharmacotherapeutic agents and develop specific treatment strategies to initiate therapies
• Develop physician-patient communication techniques to help determine patients' current medications to avoid drug-drug interactions
• Review referral algorithms for physical, speech, and occupational therapy as warranted as the disease advances
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Duke University School of Medicine and TCL Institute, LLC. The Duke University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The Duke University School of Medicine designates this educational supplement for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
