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在泰国建立阿扑吗啡治疗:了解发展中国家帕金森病管理的挑战和机遇。

Establishing apomorphine treatment in Thailand: understanding the challenges and opportunities of Parkinson's disease management in developing countries.

机构信息

Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand.

The Maurice Wohl Clinical Neuroscience Institute, King's College London and National Parkinson Foundation Centre of Excellence, King's College Hospital , London, UK.

出版信息

Expert Rev Neurother. 2020 Jun;20(6):523-537. doi: 10.1080/14737175.2020.1770598. Epub 2020 Jun 2.

DOI:10.1080/14737175.2020.1770598
PMID:32421371
Abstract

INTRODUCTION

The increasing global burden of Parkinson's disease (PD) poses a particular challenge for developing countries, such as Thailand, when delivering care to a geographically diverse populace with limited resources, often compounded by a lack of expertise in the use of certain PD medications, such as device-aided therapies (DAT).

AREAS COVERED

A panel of local, regional, and international PD experts convened to review the unmet needs of PD in Thailand and share insights into effective delivery of DAT, focusing on experience with apomorphine infusion. Despite its proven efficacy and safety, implementation of apomorphine infusion as a new option was not straightforward. This has prompted a range of health-care professional and patient-focused initiatives, led by the Chulalongkorn Center of Excellence for Parkinson's Disease and Related Disorders in Bangkok, to help establish a more coordinated approach to PD management throughout the country and ensure patients have access to suitable treatments.

EXPERT OPINION

Overcoming the challenges of education, proficiency, resource capacity and standard of care for PD patients in developing countries requires a coordinated effort both nationally and beyond. The best practices identified in Thailand following the introduction of apomorphine infusion might be helpful for other countries when implementing similar programs.

摘要

简介

帕金森病(PD)在全球的负担日益加重,对于泰国等发展中国家来说,在资源有限的情况下,为地域分布广泛的人群提供护理是一项特别的挑战,而在使用某些 PD 药物(如设备辅助治疗(DAT))方面缺乏专业知识往往会使情况更加复杂。

涵盖领域

当地、区域和国际 PD 专家小组召集会议,审查泰国 PD 的未满足需求,并分享 DAT 有效提供的见解,重点是阿扑吗啡输注的经验。尽管阿扑吗啡输注已被证明具有疗效和安全性,但作为一种新选择的实施并不简单。这促使曼谷朱拉隆功大学卓越帕金森病和相关疾病中心领导了一系列以卫生保健专业人员和患者为重点的举措,以帮助在全国范围内建立更协调的 PD 管理方法,并确保患者能够获得合适的治疗。

专家意见

克服发展中国家 PD 患者在教育、熟练程度、资源能力和护理标准方面的挑战,需要在国家内部和外部进行协调努力。在引入阿扑吗啡输注后,泰国确定的最佳实践在其他国家实施类似项目时可能会有所帮助。

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Expert Rev Neurother. 2020 Jun;20(6):523-537. doi: 10.1080/14737175.2020.1770598. Epub 2020 Jun 2.
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引用本文的文献

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Aging Dis. 2024 Nov 9. doi: 10.14336/AD.2024.1071.
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The rise of Parkinson's disease is a global challenge, but efforts to tackle this must begin at a national level: a protocol for national digital screening and "eat, move, sleep" lifestyle interventions to prevent or slow the rise of non-communicable diseases in Thailand.帕金森病的增加是一项全球性挑战,但应对这一挑战的努力必须从国家层面开始:泰国一项关于全国数字筛查以及“饮食、运动、睡眠”生活方式干预以预防或减缓非传染性疾病增加的方案。
Front Neurol. 2024 May 13;15:1386608. doi: 10.3389/fneur.2024.1386608. eCollection 2024.
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What was first and what is next in selecting device-aided therapy in Parkinson's disease? Balancing evidence and experience.
在帕金森病中选择器械辅助治疗,首先要考虑什么,接下来又该考虑什么?权衡证据与经验。
J Neural Transm (Vienna). 2024 Nov;131(11):1307-1320. doi: 10.1007/s00702-024-02782-2. Epub 2024 May 15.
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Integrating technology into a successful apomorphine delivery program in Thailand: a 10-year journey of achievements with a five-motto concept.将技术融入泰国成功的阿扑吗啡给药项目:以五理念概念历经十年取得成就的历程。
Front Neurol. 2024 Apr 5;15:1379459. doi: 10.3389/fneur.2024.1379459. eCollection 2024.
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Old problems, new solutions: harnessing technology and innovation in Parkinson's disease-evidence and experiences from Thailand.旧问题,新解决方案:利用技术和创新治疗帕金森病——来自泰国的证据和经验。
J Neural Transm (Vienna). 2024 Jun;131(6):721-738. doi: 10.1007/s00702-023-02727-1. Epub 2024 Jan 8.
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Access to device-aided therapies in advanced Parkinson's disease: navigating clinician biases, patient preference, and prognostic uncertainty.在晚期帕金森病中获得器械辅助治疗:应对临床医生偏见、患者偏好和预后不确定性。
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