Parkinson’s Care a View From General Practice

Aim

To understand the role of GPs in the care of people with Parkinson’s disease and whether that changed during COVID-19.

Headlines

• GP’s feel under confident in managing PD patients without specialist support
• There was comprehensive follow up throughout the pandemic, though the quality was likely reduced due to the limitations of remote consultations
• Some patients were managed in isolation by private neurology
• Care home patients were much more likely not to have dedicated follow up, despite being in the complex or palliative phase of their illness
• GPs were only vaguely aware of the issues around PD patients not taking their medications

Key findings

A review of the clinical records of the practice’s 30 patients with PD found:

• Eight were in care homes. Of these, only three had a specialist PD review in the last year
• 23 had been seen in a, mostly telephone, specialist clinic either once or twice
• Just 50% had had any contact with their GP in the previous year, and just five contacts were related to PD

A survey of GPs at the practice also found they were not confident in adjusting PD medications, and that they were unaware of the issues around stopping the drugs. All felt well supported by the PD service, though some were unable they were contactable by email as well as phone.

Recommendations

The project author made the following recommendations:

• Primary care should identify people with PD in care homes and refer them to specialist services
• Develop steroid-card like advice for patients on what to do if they cannot take their medication. This should include information for the GP
• Encourage GPs to use the dedicated email