Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, 44801 Bochum, Germany.
DRG MARKET, D-49069 Osnabrück, Germany.
Cells. 2019 Feb 11;8(2):151. doi: 10.3390/cells8020151.
Parkinson's disease (PD) is currently the world's fastest-growing neurological disorder. It is characterized by motor and non-motor symptoms which progressively lead to significant clinical impairment, causing a high burden of disease. In addition to pharmacological therapies, various non-pharmacological treatment options are available. A well established and frequently used multiprofessional inpatient treatment concept in Germany is "Parkinson's disease multimodal complex treatment" (PD-MCT) which involves physiotherapists, occupational therapists, speech therapists, and other specializations for the optimization of treatment in PD (ICD G20) and other Parkinsonian syndromes (ICD G21 and G23). In this study we analyze the PD-MCT characteristics of 55,141 PD inpatients who have been integrated into this therapy concept in Germany in the years 2010⁻2016. We demonstrate that PD-MCT is increasingly applied over this time period. Predominately, PD patients with advanced disease stage and motor fluctuations in age groups between 45 and 69 years were hospitalized. In terms of gender, more male than female patients were treated. PD-MCT is provided primarily in specialized hospitals with high patient numbers but a minor part of all therapies is performed in a rather large number of hospitals with each one treating only a few patients. Access to PD-MCT differs widely across regions, leading to significant migration of patients from underserved areas to PD-MCT centers ⁻ a development that should be considered when implementing such therapies in other countries. Furthermore, our data imply that despite the overall increase in PD-MCT treatments during the observational period, the restricted treatment accessibility may not adequately satisfy current patient´s need.
帕金森病（PD）是目前全球增长最快的神经退行性疾病。它的特征是运动和非运动症状逐渐导致明显的临床损伤，造成了很高的疾病负担。除了药物治疗外，还有各种非药物治疗选择。在德国，一种成熟且常用的多学科住院治疗方案是“帕金森病多模式综合治疗”（PD-MCT），涉及物理治疗师、职业治疗师、言语治疗师和其他专业人员，旨在优化 PD（ICD G20）和其他帕金森综合征（ICD G21 和 G23）的治疗。在这项研究中，我们分析了 2010 年至 2016 年期间，德国将 55,141 名 PD 住院患者纳入该治疗方案的 PD-MCT 特征。结果表明，在这段时间内，PD-MCT 的应用逐渐增加。主要住院的是疾病晚期和 45 至 69 岁年龄段出现运动波动的 PD 患者。从性别来看，接受治疗的男性多于女性。PD-MCT 主要在拥有大量患者的专科医院提供，但也有一小部分在拥有大量患者的医院中进行，每家医院仅治疗少数患者。PD-MCT 的可及性在不同地区差异很大，导致患者从服务不足的地区大量转移到 PD-MCT 中心——在其他国家实施此类治疗时应考虑到这一发展。此外，我们的数据表明，尽管在观察期间 PD-MCT 治疗总体上有所增加，但有限的治疗可及性可能无法充分满足当前患者的需求。
