The Doctor José Molina Orosa Hospital has organized a working session aimed at neurologists from the Canary Islands with the aim of improving care for people with advanced Parkinson's disease. Specifically, the objective of this session is to coordinate the care of patients who will be referred from the Lanzarote center to the Doctor Negrín Hospital in Gran Canaria. The activity will be held this Friday, June 10, from 4:30 p.m. to 8:30 p.m.
The meeting will be attended by the neurologist from Molina Orosa, Pablo Eguía, and the neurologist and head of the Movement Disorders Unit of the Doctor Negrín University Hospital of Gran Canaria, José Andrés Suárez. Pablo Eguía explains that "basically, patients with Parkinson's disease who are entering an advanced phase are referred from the Lanzarote Hospital to the Doctor Negrín Hospital, to assess the most appropriate treatments and techniques for their needs, and which are not available at the center".
The Ministry of Health explains that Parkinson's disease is a chronic, progressive, and heterogeneous pathology that affects more than 10,000 people in the Canary Islands, of which 10% have the disease in an advanced state. In these stages, people with this disease "require a personalized approach adapted to their needs by a multidisciplinary team specialized in this pathology".
As the disease progresses, both motor and non-motor symptoms stop responding adequately to conventional drugs (most of them oral), which leads to a deterioration in the autonomy of people with Parkinson's disease to carry out daily activities, they add. For these advanced stages of the disease, effective therapies have been developed that represent a significant improvement in the quality of life of people with Parkinson's disease.
A specific unit with a multidisciplinary team in Gran Canaria
In this sense, for a good management of patients and a correct implementation and monitoring of treatments, the existence of specific units is necessary, such as the Movement Disorders Unit of the Doctor Negrín University Hospital of Gran Canaria, which is made up of a multidisciplinary team of professionals specialized in Parkinson's disease, including a neurologist who works closely with a nurse and nursing assistants, the Digestive Service and other professionals such as neurosurgeons and psychologists who determine the suitability of the patient for each treatment.
"Since the late 90s and up to today, patients with a bad situation can once again have an acceptable quality of life in most cases thanks to advanced therapies. Specifically, at the Doctor Negrín Hospital we develop two aspects of the treatment. An adequate individualization and selection of advanced therapy is the key to the benefit for the patient", says Dr. José Andrés Suárez.
For his part, Dr. Eguía adds that "this multidisciplinary and interhospital approach allows the neurologists of the Doctor Negrín Hospital to know in advance those patients who we think might require these interventions". In addition, he indicates that a similar way of working is established with the reference center, which "is always beneficial for patients".
The importance in the identification of non-motor symptoms
In the early years of Parkinson's disease, motor symptoms (such as tremor, joint stiffness or slowness of movement, the most disabling) are the best known both by people with Parkinson's disease and by their families and caregivers. But this pathology also presents non-motor symptoms (constipation, urinary incontinence, behavioral and cognitive alterations, mood disorders, etc.) that are not manifested at first sight, so they are more difficult to assess. In addition, as the disease progresses, these symptoms tend to increase in number and severity, interfering in the daily activities (such as shopping or taking a walk) of people with Parkinson's disease, so they need the help of a caregiver.
"In the advanced stages of the disease, the patient is limited to do some activities, they cannot do them when they want or need to, so they need help. In addition, in these stages, that is, in patients with more than 8-10 years of evolution, it is very difficult to control involuntary movements, and other strategies are needed to improve their quality of life", says Dr. Suárez.
Regarding the treatment, effective therapies have been developed for motor symptoms, at least for the first years of the disease. "When the patient has been suffering for more than five years, they may complain of instability and postural disorders, as well as problems with gait. These alterations also do not have effective treatment, and are caused by alteration of structures not well known at present. Regarding non-motor symptoms, "some occur from the beginning of the disease and others are indicators of its progression, but, in general, their conventional medical treatment is not very "rewarding", and often condition the prognosis of the disease (such as dementia, pain, falls, etc.)", adds Dr. Suárez.
Since the symptoms can become very disabling, an adequate control of them will improve the quality of life and independence of people with Parkinson's disease and their caregivers. In this sense, good training and information, as is the case of the development of this conference, will help them to recognize these symptoms early.
"Well-structured questionnaires have been developed to facilitate their detection in consultation with the neurologist. In general, non-motor symptoms are less known than motor symptoms and, therefore, with less possibility of treatment than motor symptoms, so we must ask about them: for example, if you have difficulty sleeping and what is the problem, if blood pressure suffers variations, if you have difficulties in memory or if you have had hallucinations", concludes Dr. Suárez.