Presentation Slides: BritMODIS 2020

PEG feeding provides a means of getting food, liquid and medication into the stomach in people with Parkinsonian conditions and dysphagia. Information of survival and complications post PEG might inform feeding decisions. We audited 83 patients from 2 institutions over more than a decade. We found 30 day mortality of 6%, median survival of 387 days and rate of institutionalisation of 32%.

How nurse education in Parkinson's disease has developed in Sub Saharan Africa over the past 8 years.

Parkinson's UK is launching our next 5 year strategy for the Parkinson's community. Over the last few years we've all made an impact. It's now time to do it Bigger, Better and Faster. I'll set out plans for the Excellence Network and some exciting new initiatives

This session will discuss, with examples, of quality improvement techniques which can be readily used for improving the care of people living with Parkinson's Disease.

This presentation will cover the latest evidence for the benefits of exercise in Parkinson's, and what types of exercise are indicated. It will also address the barriers to exercise and what we can do to motivate people with Parkinson's to increase their physical activity and exercise. It will include information about initiatives and programmes designed to offer opportunities for people with Parkinson's to participate in exercise.

The aim of this talk will be to explore ways in which medication can be optimized in patients with Parkinson's disease. This will include dopaminergic medication, other pharmacological treatments used in PD, and wider prescribing issues in this patient group. The audience will be encouraged to think about ways in which they approach medicines management in patients that they see, and how this may be improved in their own localities.

Background

Patients with Parkinson’s disease (PD) who drive, may need to undergo specialist driving assessment. Driving is important in maintaining patients’ independence but there is no consensus on what predicts ability to safely drive or a validated battery of tests for use in driving assessments of PD patients.

Objectives

To describe the characteristics of PD patients assessed at a Driving Mobility Centre and investigate factors that predicted driving assessment outcome.

Methods

Retrospective cohort study of PD patients assessed between 2012-2016. Descriptive analyses and logistic models to determine factors predicting a negative outcome.

Results

There were 86 assessments of PD patients. The mean age was 70 years (±9.2), 86% were men, median disease duration 7 years (Inter Quartile Range 5-12.5 years) and 59% were referred by the DVLA. 62% had a negative “Not Drive” outcome. The best predictors were the Rookwood Driving Battery (RDB) (Odds ratio [OR] 1.45, 95% confidence interval [CI] 1.17, 1.80, p=0.001), depth of vision deficit (OR 4.95, 95% CI 1.62, 15.1, p=0.005) and usual driving frequency (International/National OR 1, Regional OR 7.33, 95% CI 1.47, 36.7, p=0.015, Local OR 4.67, 95% CI 1.39, 15.7, p=0.013) with age, duration license held and reaction time being weaker predictors in univariable analysis. The RDB score was the best predictor of assessment failure, conditional on other variables in a backward stepwise model (OR 1.29, 95% CI 1.05, 1.60, p=0.015).

Conclusions

This is the first study to describe PD patients undergoing driving assessments in the UK. We found current tests of ability are predictive of outcome. Future studies are required to determine which early disease features predict driving ability and develop simpler valid screening tests.