Posters

Introduction  Converting oral Parksinon’s disease (PD) medications to transdermal Rotigotine is sometimes required when patients have swallowing difficulties. Correct dosing is important to avoid under-treatment and deterioration of PD symptoms. Conversely, excessive dopamine agonist can cause hallucinations and confusion. In the UK, 2 main dose conversion calculators exist: PD Med Calc1 and OPTIMAL2, both utilising different formulae. We compared both to identify any dose discrepancies in their recommendations, and select one for use within revised trust guidelines.  Methods  We conducted a

Background: Previous clinical trials assessing potential disease-modifying therapies (DMTs) for Parkinson’s disease (PD) have been hugely inefficient in terms of time and resources, resulting in >10 years for a single therapy to complete phase 3 assessment. Additionally, un-representative trial populations limit the generalisability of findings. Increased efficiency of clinical trial conduct has been successfully demonstrated in multi-arm, multi-stage (MAMS) trials, which assess multiple therapies in parallel and identify ineffective therapies at early-stage analyses. New arms can be added

INTRODUCTION: Guidance around optimal management of patients with cognitive impairment within a Parkinson’s disease (PD) multidisciplinary team (MDT) is lacking. This project aimed to improve the service pathway by integrating a Parkinson’s disease specialist psychiatrist (PDSP) within the MDT rather than referring patients to a separate mental health service. METHODS: Data including mental health symptoms, time to review, diagnosis, treatment, and follow-up were collected over 12 months from the electronic clinical records of all patients referred to the PDSP with cognitive impairment. This

The UK Parkinson's Disease Clinical Studies Group The UK has a successful trial scene for Parkinson’s Disease, Multiple System Atrophy and Progressive Supranuclear Palsy neuroprotective studies, but with the growing number of trials, a formal, national structure is required to ensure the successful delivery of the studies. With funding from Cure Parkinson’s, the UK-PD-CSG launched in April-2022. The UK-PD-CSG’s goal is to further develop and support Parkinson’s clinical research across the UK and ensure more people with Parkinson’s (PwP) have the opportunity to participate in clinical trials

1. Introduction Parkinson’s Disease (PD) is a complex neurodegenerative disorder which impacts nearly all aspects of quality of life. Given the known challenges and risks of complications with PD, it is crucial to improve management prior to admission for surgery, in particular accurate medication timing and dose. Therefore a quality improvement project on this subject was initiated. 2. Method A retrospective analysis was conducted of Surgical attendances to Worthing hospital with the aim to identify patients with Parkinson’s disease (PD) admitted under their care. Each patient’s hospital

Parkinson's Disease (PD) is a progressive neurological disorder for which there is currently no cure. Palliative care should be discussed as part of PD management, both to empower patient understanding and expectations of their condition and to avoid unnecessary hospital admissions Results from the 2022 Parkinson’s UK national audit, found that the elderly care PD service in York was underperforming in having advance care planning (ACP) discussions with PD patients. The aim of this quality improvement project is to further review ACP discussions on a larger sample size and improve practice in

Background Patients living with Parkinson's disease (PD) who are sarcopenic are at significantly higher risk of falling (Cai et al., Frontiers in Neurology,2021,12,598035). Handgrip strength is a useful tool to assess for sarcopenia but is not commonly measured in clinical practice, despite the consequences that sarcopenia poses. This study aims to incorporate handgrip strength into the assessment of outpatients living with PD. Secondary objectives are to increase the understanding of whether exercise is associated with increased handgrip strength and to implement interventions for patients

Introduction Non motor symptoms (NMS) management in Parkinson disease is crucial part of the comprehensive management and have significant impact on the care and the quality of life. However, there are limitations in assessing non motor symptoms given the complexity of the symptoms , time constraint in the clinic setting and major emphasis being the motor symptoms. Objective To improve the assessment of non-motor symptoms in movement disorder clinics for the comprehensive and personalised management of patients with Parkinson disease. Service Development PD non-motor symptoms Questionnaire was

Introduction: Vitamin B12 and folate are essential for normal red blood cell production, tissue and cell repair, and DNA synthesis. B12 stores last for 3-5 years, while folate lasts for about four months. B12 or folate deficiency indicates a chronic shortage of one or both vitamins. Geriatric patients are more susceptible to Vitamin B12 and folate deficiency due to inadequate oral intake, malabsorption caused by pernicious anaemia, achlorhydria, and poor bioavailability. The clinical diagnosis is difficult in the elderly because of subtle, nonspecific, and highly variable clinical

Background Alzheimer’s disease-modifying drugs (DMDs) are in routine use in other countries. They will likely be available in the UK within the next year. It is not yet clear how many patients will be eligible for them or what resources are required to establish this eligibility. Methods Patients attending the out-patient memory clinic of a single geriatrician between 01/02/2022 and 12/01/2023 were identified. Information required to judge eligibility according to the lecanemab appropriate use recommendations (Cummings et al 2023) was extracted between 08/08/23 – 13/09/2023. Relevant data

Introduction Many patients admitted with fragility femoral fractures have established cognitive impairment but no formal diagnosis of dementia. This lack of pre-existing diagnosis impacts care, counselling and discharge planning. This audit assessed how many people aged >65 admitted with a fragility fracture had information, at the time of admission, suggesting a likely but unconfirmed diagnosis of dementia and how their length of stay (LOS) and discharge destination compared to patients with confirmed dementia. Methods 47 consecutive patients aged >65, admitted with a fragility femoral

Introduction: Neuroimaging plays an important role in assessing patients referred to a memory assessment service. CT scans are a cost-effective option and are useful to identify other causes of cognitive impairment and provide valuable information regarding the subtype of dementia. In our trust, there is no standardised request proforma for CT head scans and not all relevant criteria have been included that are in line with the guidance from the British Society of Neuroradiologists (BSNR) proposed structure dementia template for routine clinical practice. This audit aims to assess CT head scan

This Quality Improvement Project (QIP) addresses the pressing need for increased awareness of delirium among patients' relatives. With a 26% rise in the elderly population in Cambridgeshire, surpassing the 18.6% national average, the project aimed to provide crucial information to enhance understanding and support for patients grappling with delirium, a condition affecting up to 50% of elderly hospital patients. This prospective study was conducted across seven geriatric wards at Cambridge University Hospital (CUH). Baseline measurements utilized existing data on CUH Delirium website views and

Introduction: Frailty is an important consideration in the health and wellbeing of older adults, particularly as it is associated with a risk of falls, and mental health difficulties such as depression. There has been no validation of frailty assessment tools among older adults with Psychiatric disorders. This was a feasibility study exploring the use of the Edmonton frail scale (EFS) among patients with highly complex mental health needs within a Psychiatric Inpatient Setting with a view to develop a service integration process leading to further research. Methods: 45 participants were

Introduction: Digital technologies can play a significant role in addressing care needs of older people. The process of establishing an effective and efficient digital engagement with older people demands multi-sectoral collaboration from various stakeholders including non-governmental organizations. The role non-governmental organizations play in such digital programs, their process of engagement with older people and factors which influence such multi-sectoral collaboration is an under researched area. Methods: A scoping review was performed to map existing literature on older people’s

Introduction: Any Frailty Index (FI) measures overall health. The FI-Lab employs common laboratory data and clinical measures to do so. Objective: To examine how an FI-lab constructed from vital signs, laboratory tests, and electrocardiographic data is associated with in-patient admission and time to death. FI-Lab performance was compared with an FI from a Comprehensive Geriatric Assessment (FI-CGA), the Clinical Frailty Scale (CFS), and the Canadian Triage Acuity Scale (CTAS). Methods: Participants were Emergency Department (ED) patients aged 65+ years referred to Internal Medicine, staffed

Introduction Effective bowel care is a key part of patient care which involves the accurate documentation of bowel movements. Older patients are at higher risk of delirium and increased length of stay if constipation and diarrhoea are not recognised. We aimed to identify the quality of bowel chart documentation comparing the use of paper and electronic bowel charts. Methods Data was collected on whether bowel charts were filled in at two timepoints over a two-day period. The first cycle in September 2020 using paper bowel charts and the second cycle in June 2023 using electronic bowel charts

Background NICE (2023) Shared Decisions Making (SDM) Guidelines ensure Health Care professionals work together with a person to reach a decision about care based on their individual preferences, beliefs, and values. Local Problem We conducted an Audit across our community services to assess NICE SDM, achieving 71% compliance. Results informed the project problem statement “Clinical Teams are not fully compliant to NICE SDM guidelines therefore a shared decision-making approach is not guaranteed”. Methods A fishbone diagram was applied to understand why SDM wasn’t routinely occurring in

Introduction: Reducing inappropriate polypharmacy is a major public health goal and deprescribing is considered one potential solution. Although patient attitudes towards deprescribing have been well studied, little consideration has been given to the informal caregiver perspective, how this differs from the views of patients and how that might influence care. Method: A survey including demographic questions and the revised Patients’ Attitude Towards Deprescribing (rPATD) questionnaire was undertaken. The primary outcome was to identify the willingness of respondents to deprescribe. This

Over the last 12 months, an oncogeriatric clinic was successfully established to assess frail 2-week wait (2WW) patients referred with upper and lower gastrointestinal (GI) symptoms. The clinic was initially funded by the West Yorkshire Cancer Alliance, enabling a weekly clinic, run by a geriatrician, clinical specialist nurse and an advance clinical practitioner. A total of 350 patients were assessed, with only a third of them remaining on the 2WW pathway compared to traditional surgical patients; this was due to patients being too frail or an alternative diagnosis being made through