Abstract

In the UK, guidance exists to aid clinicians and patients deciding when treatment for Parkinson’s disease (PD) should be initiated and which therapies to consider. National Institute for Health and Care Excellence (NICE) guidance recommends that before starting PD treatment clinicians should discuss the following: the patient’s individual clinical circumstances; lifestyle; preferences; needs and goals; as well as the potential benefits and harms of the different drug classes. Individualization of medicines and management in PD significantly improves patients’ outcomes and quality of life. This article aims to provide simple and practical guidance to help clinicians address common, but often overlooked, co-morbidities. A multi-disciplinary group of PD experts discussed areas where clinical care can be improved by addressing commonly found co-morbidities in people with Parkinson’s (PwP) based on clinical experience and existing literature, in a roundtable meeting organized and funded by Bial Pharma UK Ltd. The experts identified four core areas (bone health, cardiovascular risk, anticholinergic burden, and sleep quality) that, if further standardized may improve treatment outcomes for PwP patients. Focusing on anticholinergic burden, cardiac risk, sleep, and bone health could offer a significant contribution to personalizing regimes for PwP and improving overall patient outcomes. Within this opinion-based paper, the experts offer a list of guiding factors to help practitioners in the management of PwP.

中文翻译：

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解决帕金森病患者的合并症：专家小组的考虑

摘要

在英国，已有指南帮助临床医生和患者决定何时开始帕金森病 (PD) 治疗以及考虑哪种治疗方法。美国国家健康与护理卓越研究所 (NICE) 指南建议，在开始 PD 治疗之前，临床医生应讨论以下内容： 患者的个人临床情况；生活方式; 优先; 需求和目标；以及不同药物类别的潜在益处和危害。PD 的个体化药物和管理可显着改善患者的治疗结果和生活质量。本文旨在提供简单实用的指导，帮助临床医生解决常见但经常被忽视的合并症。在由 Bial Pharma UK Ltd 组织和资助的圆桌会议上，多学科帕金森病专家小组根据临床经验和现有文献，讨论了可以通过解决帕金森病 (PwP) 患者常见并发症来改善临床护理的领域专家们确定了四个核心领域（骨骼健康、心血管风险、抗胆碱能负担和睡眠质量），如果进一步标准化，可能会改善 PwP 患者的治疗结果。关注抗胆碱能负担、心脏风险、睡眠和骨骼健康可以为 PwP 的个性化治疗方案和改善患者的整体预后做出重大贡献。在这篇基于意见的论文中，专家们提供了一系列指导因素来帮助从业者管理 PwP。