Posts Tagged ‘primary care physicians’
Parkinson’s disease is a complex constellation of symptoms requiring the care of a neurologist. As reported in the August 30, 2011 issue of Neurology, Parkinson patients can have a greatly improved quality of life and long-term clinical well being under the care of a neurologist. Parkinson disease affects approximately 1 million Americans. It is only second to Alzheimer’s disease as a common neurodegenerative illness. Early diagnosis, recognition of associated symptoms and comorbidities with comprehensive care are necessary if a Parkinson patient’s long term quality of life are to be optimized.
Neurology involves a vast scope of illnesses, each requiring intimate knowledge and understanding of the disease process as well as the treatment required to optimized patient well being and life quality.
Across the United States, 15-20% of all visits to a primary care doctor’s office (family physician or internal medicine) involve a neurological complaint. While simple problems such as back or neck pain can easily be treated, more complicated illnesses such as Parkinson’s disease, migraine headaches, seizures and multiple sclerosis should be managed by a neurologist. Surveys in the United States and Europe show that both medical students and general physicians do not feel as comfortable in managing neurological problems as they do other medical problems. The article in Neurology showed that Parkinson disease patients, managed by a neurologist, have better outcomes than those managed by primary care physicians.
Parkinson patients managed by neurologists, generally have an earlier diagnosis. This leads to earlier treatment. With this, patient functioning can be maintained and optimized. This allows for the patient and their families to enjoy more quality time together with an increased ability to engage in social activities and travel.
The Neurology study, involved over 138,000 Parkinson patents over the age of 65. The study showed that about 20% of patents with Parkinson’s disease never see a neurologist. These patients had a higher rate of falling, hip fractures, admission to nursing homes and shorter survival rate.
Parkinson patents cared for by a neurologist, by contrast, significantly had fewer hip fractures. Hip fractures are a major cause of disability and death in the elderly. Inherent to Parkinson patients is gait instability and a tendency to fall. Falling prevention is a main goal in all elderly patients, but particularly those with Parkinson’s disease. Unfortunately, many who suffer a hip fracture may become wheelchair confined, even with successful hip fracture repair. One third of all patients who suffer a hip fracture will die within a year of their fracture! With detailed care of Parkinson patients’ symptoms, a neurologist can better help these patients from falling and prevent major injuries.
This study also showed that Parkinson patients getting state-of-the-art care by a neurologist had a lower probability of being admitted to a nursing home. While most Parkinson patients do not need nursing home care, those with more advanced disease, Parkinson-related dementia or complications such as hip fractures frequently need skilled nursing facility placement.
Parkinson’s disease is complex. Not only are the motor symptoms a major problem, but so are the cognitive and psychological problems that go along with this disease. Depression and anxiety occur in over fifty percent of Parkinson patients. Early recognition and treatment of this is critical for improved patient and caregiver quality of life. Dementia is also a common problem. It can start as mild memory loss but will progress to dementia. Neurologists are sensitive to these problems and there are medications that can help.
The final finding of the Neurology study was that the six-year survival of Parkinson’s disease patients, managed by neurologist, was significantly increased. There are multiple reasons why this may be the case, including earlier use of the many types of medications used in Parkinson management, treatment of coexisting psychiatric problems and addressing the multitude of other medical problems that are frequently associated with Parkinson’s disease.
The conclusion for Parkinson patients and their family or caregivers is to get that patient in to see a neurologist, particularly one who specializes in movement disorders.
Patients want more control over their life, improved quality of life and the ability to remain functional as long as possible. This is true for the Parkinson patient as well. Take control of your life; contact a neurologist who specializes in Parkinson’s disease for consultation and management. It will most likely be the best thing you could do for yourself – for the rest of your life.