Hospitalization in Parkinson's disease: a survey of UK neurologists, geriatricians and Parkinson's disease nurse specialists

Introduction: Care for people with Parkinson's admitted to hospital is often suboptimal and services for these patients vary. We conducted a national survey to document current service provision in the UK and to explore clinicians' views on standards of care and potential service improvements.

Method: We used the mailing lists of British Geriatric Society Movement Disorder Section (BGS-MDS), British and Irish Neurologists' Movement Disorders Group (BRING-MD), and Parkinson's Disease Nurse Specialists Association (PDNSA) and invited participation by email with a link to an online survey (www.surveymonkey.com). The survey was posted in spring 2014 for six weeks.

Results: There were 93 respondents from at least 65 different hospitals. The estimated response rate was 19%. Respondents were: 35 consultant geriatricians; 21 consultant neurologists, 29 Parkinson's Disease Nurse Specialists (PDNS), 8 others. 81% respondents report their hospital has a PDNS. 79% have a geriatrician with an interest in Parkinson's. 54% have a Parkinson's clinical guideline, 16% a cohort/specialist ward for Parkinson's and 11% an electronic system for flagging Parkinson's admissions. 21% rated overall standard of care as poor. 61% were not confident that medications were given on time. Having a PDNS see all Parkinson's in-patients, flagging of Parkinson's admissions and having a Parkinson's outreach service were ranked most likely of 16 potential service developments to improve care.

Conclusion: Care for Parkinson's in-patients is not highly rated by UK Parkinson's clinicians. Interventions to improve care need to be studied but wide variations in current service provision pose a challenge for future study design.