By: Eleanor McDermid

A randomized controlled trial showed an improvement in outcomes when Parkinson's patients are treated by a multidisciplinary treatment team.

Researchers compared quality of life and motor function between patients treated by general neurologists and those treated by a multidisciplinary team of therapists, including movement specialists, Parkinson's nurses and social workers.

"Due to the fact that the multidisciplinary group included a specialist in movement disorders, we cannot be sure that the differences in the results were due to him or that they were due to the "group" say the author of the article on the study Mark Guttman (University of Toronto Ontario Canada) and his research partners. They suggest that in the next step results will be compared after Treatment by a general neurologist alone and in combination with the multidisciplinary group. A comparison between treatment with a movement disorders specialist and a movement disorders specialist + the multidisciplinary group can create a "overlap effect" (a situation in which there is a maximum possible improvement in the treatment of the movement disorders specialist and thus the addition of the multidisciplinary group does not add Mauma), they point out, and in addition comment that there is often a shortage of movement disorder specialists who are reserved for the seriously ill.

During the eight months of the study, the quality of life determined according to the Parkinson's disease questionnaire (PDQ-39) decreased somewhat in the 49 patients who received treatment from a general neurologist, by 1.4 points on average. In contrast, the quality of life score improved by 2.5 points in 51 patients who received treatment from the multidisciplinary group, which created a difference of 3.4 points difference between the two groups. "Such an improvement will be clinically significant for patients," the researchers wrote in the monthly MOVEMENT DISORDERS. The patients knew which treatment group they belonged to (it was impossible to prevent this), but they were asked not to reveal this to the attending physicians and researchers who were not aware of this information.

Multidisciplinary treatment was accompanied by a significant improvement in PDQ-39 subcategories, mobility, daily activity and emotional resilience, but not in regards to stigma, social support, memory, communication and physical discomfort.

The secondary outcome of a change in UPDRS (Unified Parkinson's Disease Rating Scale) was significant depending on the group affiliation, with patients treated by the multidisciplinary group showing an improvement of 2.7 points compared to a decrease of 1.6 points in the control group.

"The improvement falls within the same range where its effect is seen, as reported in clinical trials on the effect of dopaminergic drug therapy" say Gutman and his research partners. "Although a direct comparison with drug treatment is difficult, the changes in motor function appear to be clinically significant for patients."

A third result was seen in the improvement in depression and psychological functioning in the group treated by the multidisciplinary group compared to routine treatment.

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