Interventions and outcomes with a Parkinson’s Disease Fellow Home Visit Service

Introduction: People living with advanced Parkinson’s Disease (PD) and Atypical Parkinsonian Syndromes (APS) often experience reduced mobility. This may result in difficulty attending specialist outpatient clinics, and consequently reduced access to review potentially complex symptoms. Therefore, there is a potential unmet need for people living with these conditions to have ongoing specialist medical input in community settings. Objectives: To record common interventions and outcomes following a Parkinson’s Disease Fellow Home visit.

Method: People identified for a Home visit by a PD Multi-Disciplinary Team (MDT) were reviewed at home by a Senior Clinical Fellow Physician working in the PD MDT. Common interventions and outcomes were recorded over the 10 month service period.

Results: 46 people reviewed over 52 home visits in 10 months. The most common interventions were Advance Care Planning (52.0%), de-prescribing (34.8%), referral to community services (32.6%) and optimising or commencing Dopaminergic medications (30.4%). 14 people (30.4%) died during the 10 month project period, and 71% of those died at their normal place of residence.

Conclusion: This service evaluation suggests clinically meaningful benefits of PD Fellow home visits for people living with advanced PD and Atypical Parkinsonian Syndromes. This can include holistic medical interventions and supporting preferences for preferred place of care and death.