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J Neural Transm (Vienna) ; 125(10): 1461-1472, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30167934

RESUMEN

To close a gap between inpatient and outpatient care, the Hamburg Parkinson day-clinic (HPDC) has been developed as a new and comprehensive, individual, interdisciplinary type of treatment for patients with complex Parkinsonian syndromes (PS). First, we describe the HPDC concept, in which a multi-professional medical team of PD specialists provide a time- and personnel-wise intensive care and focuses on the patients' individual deficits and resources. Second, we present short-term outcome results of the first 184 PS patients enrolled during 16 months including objective clinical motor and non-motor scores taken before and after participation in the HPDC, as well as the patients' subjective evaluation of the HPDC. Out of the 184 patients with PS (aged 39-88 years with Hoehn and Yahr scores between 1.0 and 4.5), 169 were diagnosed to have Parkinson disease (PD). HPDC treatment led to improvement of all applied motor (UPDRS III, AIMS) and non-motor (BDI-II, MoCA, PDNMS, PDSS-2, King's PD Pain Scale, QUIP, PDQ-39) scores (p < 0.05) indicating benefits for akinesia, tremor, dyskinesia, cognition, sleep, pain, impulse control disorders and quality of life. Patients evaluated HPDC care positively with values from 1.39 to 2.79 ("very good" to "satisfying") with an overall grade of 1.69 ("good") on a 6-point Likert scale (1-6: best to worst). Patients with advanced PS benefit from the HPDC concept which is considered to close a gap between inpatient and outpatient care.


Asunto(s)
Atención Ambulatoria/métodos , Centros de Día/organización & administración , Servicio Ambulatorio en Hospital/organización & administración , Enfermedad de Parkinson/terapia , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Femenino , Alemania , Humanos , Comunicación Interdisciplinaria , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/enfermería , Enfermedad de Parkinson/rehabilitación , Grupo de Atención al Paciente , Medición de Resultados Informados por el Paciente , Medicina de Precisión , Recuperación de la Función , Índice de Severidad de la Enfermedad
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