By Mike Foster
Parkinson’s patients face long waiting times for follow-up appointments and a bewildering array of hundreds of physiotherapy, geriatric and community care access centres. However, the Integrated Parkinson’s Care Network (IPCN), an initiative of uOttawa’s Brain and Mind Research Institute (uOBMRI), is testing new ways to streamline care, according to Dr. David Grimes, head of the Ottawa Hospital clinic for movement disorders.
Since last year, the IPCN has hired an integrated care coordinator and established a database of services available to Parkinson’s patients in the Ottawa region. In late July, a handful of Parkinson’s patients began to receive personalized care maps, which set out details of the care they need.
These are just a few steps forward taken at the IPCN that Grimes and his uOBMRI colleagues, including Drs. Tiago Mestre, Adam Sachs and Michael Schlossmacher, will describe as part of uOBMRI Brain Health Awareness Week, Monday, September 14.
“We are trying to show that we can deliver better care to complex patients in a more cost-effective way,” says Grimes.
Past attempts by others to deliver the much-needed multidisciplinary care to Parkinson’s patients were abandoned because they were so expensive, he adds.
Grimes, who was involved in writing the Canadian guidelines for treating Parkinson’s patients, says the database will help doctors and health workers provide information on all of the care options available in the Ottawa region, including whether they are public or private. The network hopes to link the database to Ontario’s new e-consultation service, which provides family doctors with rapid access to specialists’ medical advice.
One issue both nationally and locally is that patients with Parkinson’s can wait up to a year to receive treatment at specialized movement disorder clinics. Once they are seen by a specialist, they can wait up to 10 months for a follow-up appointment.
“Clearly that is not ideal for providing care,” says Grimes. A care coordinator will provide care for minor ailments while monitoring Parkinson’s patients that might require more urgent follow-up.
The IPCN also aims to improve clinical research, overseen by Mestre. Patients, who will be told about various new treatments that are available to them, will provide valuable clinical outcomes data and bio-samples. The IPCN will apply for research funds to study whether its model does make a cost-effective difference for Parkinson’s patients, with results due at the end of 2016.
“We have many different research programs. This (research) involves diagnostic, biomarker work, new medications coming to market as well as investigator-driven treatment options, but is there any evidence that they really work? Unfortunately, for Parkinson’s, we do a lot of things but there is not a lot of evidence that we are doing the right things. This research will address these shortcomings,” says Grimes.