Department of Neurology, University of Michigan, Ann Arbor, MI 48109-5316, USA.
Parkinsonism Relat Disord. 2011 Jul;17(6):440-5. doi: 10.1016/j.parkreldis.2011.03.002. Epub 2011 Apr 1.
To explore current practices and opinions regarding hospital management of Parkinson disease (PD) patients in specialized PD Centers.
Fifty-one out of 54 National Parkinson Foundation (NPF) Centers worldwide completed an online survey regarding hospitalization of PD patients.
Many Centers were concerned about the quality of PD-specific care provided to their patients when hospitalized. Primary concerns were adherence to the outpatient medication schedule and poor understanding by hospital staff of medications that worsen PD. Few Centers had a policy with their primary hospital that notified them when their patients were admitted. Rather, notification of hospitalization came often from the patient or a family member. Several Centers (29%) reported not finding out about a hospitalization until a routine clinic visit after discharge. Quick access to outpatient PD care following discharge was a problem in many Centers. Elective surgery, fall/fracture, infection, and mental status changes, were identified as common reasons for hospitalization.
There is a perceived need for PD specialists to be involved during hospitalization of their patients. Improvement in communication between hospitals and PD Centers is necessary so that hospital clinicians can take advantage of PD specialists' expertise. Education of hospital staff and clinicians regarding management of PD, complications of PD, and medications to avoid in PD is critical. Most importantly, outpatient access to PD specialists needs to be improved, which may prevent unnecessary hospitalizations in these patients.
探索在专门的帕金森病（PD）中心，医院对 PD 患者管理的当前实践和观点。
全球 54 个国家帕金森基金会（NPF）中心中的 51 个中心完成了一项关于 PD 患者住院的在线调查。
许多中心关注 PD 患者住院期间提供的 PD 特异性护理的质量。主要关注点是坚持门诊用药方案和医院工作人员对加重 PD 的药物的理解不佳。很少有中心与主要医院有政策规定，当他们的患者住院时通知他们。相反，住院通知通常来自患者或其家属。一些中心（29%）报告说，直到出院后的常规诊所就诊才了解到住院情况。许多中心在出院后快速获得门诊 PD 护理存在问题。择期手术、跌倒/骨折、感染和精神状态改变被确定为常见的住院原因。
人们认为 PD 专家在患者住院期间需要参与。有必要改善医院和 PD 中心之间的沟通，以便医院临床医生能够利用 PD 专家的专业知识。对医院工作人员和临床医生进行 PD 管理、PD 并发症以及避免用于 PD 的药物方面的教育至关重要。最重要的是，需要改善 PD 专家的门诊服务，这可能会防止这些患者不必要的住院治疗。
