Patient care for those with Parkinson’s disease often falls short in hospitals, where they are hospitalized more frequently than their peers without the condition. Annie Brooks, MSW, senior director of strategic initiatives at the Parkinson’s Foundation, states that understanding PD needs is essential for quality care, regardless of the reason for hospitalization.
Brooks notes that 1 in every 6 people with PD experience complications while in the hospital, highlighting the need for better clinician resources. The Parkinson’s Foundation has created a pair of tools to address this gap: a Parkinson’s Disease in the Emergency Department Toolkit and a continuing education course titled “Bridging Hospital Care Transitions from the Emergency Department to Outpatient.”
These resources aim to help hospital clinicians understand the importance of maintaining a person’s Parkinson’s medication regimen during hospitalization. Brooks emphasizes that PD medications are as essential to someone with Parkinson’s as insulin is to someone with diabetes, and that delayed, missed, or contraindicated medications can trigger a harmful cycle of complications.
One of the most preventable mistakes hospitals can make is holding PD medications when it is not absolutely essential to do so. Halting the patient’s PD medications or departing from their at-home schedule risks disturbance of physical, cognitive, and swallow functions, compromising acute care and increasing the risk for complications.
Brooks recommends that hospitals expedite medication reconciliation for PD patients, ideally flagging it for an ED pharmacist at check-in. Ensuring that the patient’s next dose of Parkinson’s medications is given on time is also important. The Parkinson’s Disease in the Emergency Department Toolkit provides a roadmap for implementing these interventions, which have been associated with decreased length of stay and decreased use of injectable antipsychotic or benzodiazepine.
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Building an alert to expedite medication reconciliation and removing standard ordering options in the electronic health record for PD medication can help ensure that a patient’s PD symptoms don’t become a secondary problem.
Communication breakdowns often occur across the care team, but can be prevented by building pathways for cross-departmental communication and establishing methods of communication. Clinicians can better partner with patients and caregivers during hospitalization by listening to their concerns and eliciting their support in providing reminders for medication timing.
By adopting these recommendations, hospitals can expect improved outcomes for people with PD, including decreased administration of contraindicated medications and shortened length of stay.
Brooks hopes that clinicians remember the importance of PD medication management for quality care and improved outcomes. For those looking to improve hospital safety for people with PD, the Parkinson’s Foundation provides a place for peer-learning and support through the Hospital Care Learning Collaborative, where they can learn about stress and burnout rates affecting healthcare professionals.
Hospitals must prioritize PD care.