Treatment Strategies and Quality-of-Care Indicators for Patients With Parkinson's Disease

BACKGROUND: Parkinson's disease (PD) is a chronic, progressive, and debilitating disease, which affects over 1 million people in the United States. PD is characterized by a loss of voluntary and involuntary muscle control. As the disease progresses, additional complications can arise in the form of nonmotor and neurobehavioral symptoms. The traditional pharmacologic treatment for PD has been levodopa. While levodopa is effective for reducing the symptoms of PD, it is associated with long-term complications such as motor fluctuations and dyskinesias. More recently,several pharmacological agents have been implemented for the treatment of PD at various stages in the disease course. Specific indicators have been developed that will allow health care practitioners to improve the diagnosis,treatment, and quality of care for patients with PD. OBJECTIVES: To familiarize managed care professionals with treatment options in the management of PD based on current practice guidelines and clinical evidence, and to consider a set of quality-of-care indicators to improve symptom assessment and treatment strategies for patients with PD. SUMMARY: A variety of treatment options should be evaluated on an individual basis to optimize management of PD at all disease stages. A set of quality-of-care indicators and treatment recommendations have been developed to assist health care providers and managed care professionals in improving and optimizing clinical outcomes for patients with PD.