Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330, Thailand.
The Academy of Science, The Royal Society of Thailand, Bangkok, 10330, Thailand.
J Neural Transm (Vienna). 2024 Jun;131(6):721-738. doi: 10.1007/s00702-023-02727-1. Epub 2024 Jan 8.
The prevalence of Parkinson's disease (PD) is increasing rapidly worldwide, but there are notable inequalities in its distribution and in the availability of healthcare resources across different world regions. Low- and middle-income countries (LMICs), including Thailand, bear the highest burden of PD so there is an urgent need to develop effective solutions that can overcome the many regional challenges associated with delivering high-quality, and equitable care to a diverse population with limited resources. This article describes the evolution of healthcare delivery for PD in Thailand, as a case example of a LMIC. The discussions reflect the author's presentation at the Yoshikuni Mizuno Lectureship Award given during the 8th Asian and Oceanian Parkinson's Disease and Movement Disorders Congress in March 2023 for which he was the 2023 recipient. The specific challenges faced in Thailand are reviewed along with new solutions that have been implemented to improve the knowledge and skills of healthcare professionals nationally, the delivery of care, and the outcomes for PD patients. Technology and innovation have played an important role in this process with many new tools and devices being implemented in clinical practice. Without any realistic prospect of a curative therapy in the near future that could halt the current PD pandemic, it will be necessary to focus on preventative lifestyle strategies that can help reduce the risk of developing PD such as good nutrition (EAT), exercise (MOVE), good sleep hygiene (SLEEP), and minimizing environmental risks (PROTECT), which should be initiated and continued (REPEAT) as early as possible.
帕金森病(PD)在全球范围内的患病率正在迅速上升,但在不同世界区域,其分布和医疗保健资源的可及性存在显著不平等。包括泰国在内的低收入和中等收入国家(LMICs)承担着 PD 的最高负担,因此迫切需要制定有效的解决方案,以克服与向资源有限的多样化人群提供高质量和公平的护理相关的许多区域挑战。本文描述了泰国 PD 医疗保健服务的演变,作为 LMIC 的一个案例研究。讨论反映了作者在 2023 年 3 月举行的第 8 届亚洲和大洋洲帕金森病和运动障碍大会上进行的 Yoshikuni Mizuno 讲座奖的演讲内容,他是该奖项 2023 年的获得者。本文回顾了泰国所面临的具体挑战,以及为提高全国医疗保健专业人员的知识和技能、提供护理和改善 PD 患者的治疗效果而实施的新解决方案。技术和创新在这一过程中发挥了重要作用,许多新工具和设备已在临床实践中得到应用。在可预见的未来,没有任何可以治愈 PD 的治疗方法来阻止当前的 PD 流行,因此有必要关注可以帮助降低 PD 发病风险的预防生活方式策略,例如良好的营养(EAT)、运动(MOVE)、良好的睡眠卫生(SLEEP)和最小化环境风险(PROTECT),这些策略应尽早开始并持续(REPEAT)。