Pedersen Stephen W, Suedmeyer Martin, Liu Louis W C, Domagk Dirk, Forbes Alison, Bergmann Lars, Onuk Koray, Yegin Ashley, van Laar Teus
Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Copenhagen, Denmark.
Department of Neurology, University of Düesseldorf, Düesseldorf, Germany.
J Multidiscip Healthc. 2017 Jan 4;10:13-27. doi: 10.2147/JMDH.S111369. eCollection 2017.
A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies.
帕金森病（PD）治疗指南越来越推荐采用多学科团队（MDT）方法，但目前尚无该方法的护理标准，且指南未对其实施方式作出明确说明。本文回顾了针对PD患者的MDT干预证据，并提供了MDT方法的专家临床观点，重点关注晚期PD和左旋多巴 - 卡比多巴肠凝胶（在美国为卡比多巴 - 左旋多巴肠内混悬液）。关键建议包括：通过促进在固定网络结构中工作的不同医疗保健专业人员进行密切的结构化协作，在当地为PD患者提供尽可能最佳的治疗；及时将PD患者转诊至已建立的MDT中心；为MDT定期召开会议，以促进跨学科交流与学习；优化个体化治疗并仔细评估可用的治疗方案；确保PD患者、其护理人员、家人和医疗保健专业人员共同商定治疗决策；在实施高级疗法时，必要时纳入来自辅助医疗部门的非神经科专家。
