Movement Disorders Center, Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
J Parkinsons Dis. 2012;2(2):79-86. doi: 10.3233/JPD-2012-12075.
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease, and it is characterized by a complex variety of both motor and neuropsychiatric issues. Effective treatment of PD symptoms requires a combination of pharmacotherapy and allied health therapies; however, treatment is generally monodisciplinary, with the neurologist referring out to varied therapists as needed. In order to more effectively manage PD as it progresses over time, clinics are beginning to implement and advocate the use of more integrative models of care for PD. In order to understand the effectiveness of these models, a comprehensive literature review was conducted through electronic searches of PubMed, Academic Search Premier, PsycINFO, Health Source: Nursing/Academic Edition, AgeLine, AMED (Alternative Medicine), Health and Psychosocial Instruments, Health Source - Consumer Edition, and Social Work Abstracts databases. The review identified only two published studies, both of which only evaluated the effectiveness of multidisciplinary care in outpatient settings. The results of the studies indicated that multidisciplinary treatment led to marked improvement in patient outcomes; however, these results are limited as they measured short term outcomes only. The limited available evidence on the efficacy of integrative healthcare delivery models in PD should serve as a call-to-action for clinicians to work to improve the care, and subsequently the quality of life, of PD patients through streamlining PD-specialized care with multiple complementary clinicians and incorporating patient preferences and goals into treatment.
帕金森病（PD）是仅次于阿尔茨海默病的第二常见神经退行性疾病，其特征是运动和神经精神问题的复杂多样性。有效治疗 PD 症状需要药物治疗和联合健康治疗的结合；然而，治疗通常是单一学科的，神经科医生根据需要将患者转诊给各种治疗师。为了更有效地随着时间的推移管理 PD，诊所开始实施并提倡使用更综合的 PD 护理模式。为了了解这些模式的有效性，通过对 PubMed、Academic Search Premier、PsycINFO、Health Source: Nursing/Academic Edition、AgeLine、AMED（替代医学）、Health and Psychosocial Instruments、Health Source - Consumer Edition 和 Social Work Abstracts 数据库进行电子搜索，进行了全面的文献综述。该综述仅确定了两项已发表的研究，这两项研究都仅评估了多学科护理在门诊环境中的有效性。研究结果表明，多学科治疗导致患者结局显著改善；然而，这些结果是有限的，因为它们仅测量短期结果。关于综合医疗保健提供模式在 PD 中的疗效的有限可用证据应该作为一个行动呼吁，呼吁临床医生通过与多名互补临床医生简化 PD 专科护理并将患者的偏好和目标纳入治疗来努力改善 PD 患者的护理，并随后改善他们的生活质量。
