Development of a New Care Pathway for Depression and Anxiety in Adult-Onset Isolated Dystonia.
Mov Disord Clin Pract
; 10(3): 415-426, 2023 Mar.
Article
em En
| MEDLINE
| ID: mdl-36949792
ABSTRACT
Background:
Recently, we identified barriers and facilitators to the screening and treatment of depressive and anxiety symptoms in adult-onset isolated dystonia (AOID). These symptoms are common, functionally impairing, and often underdetected and undertreated.Objectives:
To develop a care pathway for mood symptoms in AOID.Methods:
We used a multistep modified Delphi approach to seek consensus among healthcare professionals with experience of AOID on the screening, diagnosis, and treatment of mood symptoms. A combination of face-to-face meetings and online surveys was performed from 2019 to 2020. We created the survey and then reviewed with stakeholders before 2 rounds of Delphi surveys, all of which was finally reviewed in a consensus meeting. A purposive sample of 41 expert stakeholders from 4 Canadian provinces, including neurologists, nurses, psychiatrists, psychologists, and family physicians, was identified by the research team.Results:
The Delphi process led to consensus on 12 statements that operationalized a pathway of care to screen for and manage depression and anxiety in people with AOID. Key actions of the pathway included yearly screening with self-rated instruments, multidisciplinary involvement in management involving local networks of providers coordinated by movement disorders neurologists, and access to educational resources. The Delphi panel indicated the 2 core steps as the documentation of the most recent screening outcome and the documentation of a management plan for patients who were positive at the last screening.Conclusions:
This new care pathway represents a potentially useful intervention that can be used to build an integrated model of care for AOID.
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MEDLINE
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En
Ano de publicação:
2023
Tipo de documento:
Article