AN AUDIT OF PARKINSON'S DISEASE MANAGEMENT

Background Currently, PD is managed either in general neurology or specialist clinics. The NICE guideline on PD is the standard of care, summarized in the Parkinson9s UK audit tool (PUKAT). Objective Comparing the care of PD patients between specialist-led and general neurology clinics in our trust. Methods Using the PUKAT, we audited documentation of the following, over a one-year period in patients under (‘Specialist’ group, n=20) and not under the care of a specialist movement disorder neurologist (‘General’ group, n=20): frequency of review; medication side effects including hypersomnolence and its effects on driving, and impulse control disorders (ICDs); reviewing motor and non-motor symptoms, and need for multi-disciplinary care. Results Review rate within last year was: Specialist 100% vs. General 90%. Rates of documentation of issues were: hypersomnolence: 84% vs.45%; advised against driving if hypersomnolent: 52% vs 22%; ICDs in patients on dopamine agonists: 100% vs. 50%; non-motor (9 vs. 3 points, max. 12) and motor symptoms (11 vs. 3 points, max. 12); need for MDT input (9 vs 3 points, max. 10) Conclusions Compliance with NICE guidelines on PD management in better in specialist-led clinics than in general neurology clinics which has implications for resourcing the care of PD patients.