Analysis

Revolutionising management of chronic disease: the ParkinsonNet approach

BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g1838 (Published 19 March 2014) Cite this as: BMJ 2014;348:g1838
  1. Bastiaan R Bloem, professor of movement disorder neurology12,
  2. Marten Munneke, director ParkinsonNet23
  1. 1Department of Neurology, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, Netherlands
  2. 2Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen
  3. 3Nijmegen Centre for Evidence Based Practice, Nijmegen
  1. Correspondence to: B R Bloem bas.bloem{at}radboudumc.nl
  • Accepted 11 February 2014

Patients with Parkinson’s disease need long term support to manage their condition. Bastiaan Bloem and Marten Munneke describe the benefits of a model of integrated care provided by a network of specialists and suggest it has promise for other long term conditions

Advances in medical knowledge and technology, escalating healthcare costs, and rising patient expectations and involvement in their care are changing the management of chronic disease. Here, we describe how ParkinsonNet, an innovative regional network introduced in the Netherlands in 2004, has improved the quality of care and reduced the healthcare costs of patients with Parkinson’s disease. The scheme uses a select group of trained health professionals linked together through a shared online platform to which patients also have access.

Care of patients with Parkinson’s disease

Parkinson’s disease is a common and disabling neurodegenerative disorder.1 A Dutch study of 6969 community residents aged ≥55 years showed a prevalence of 1.4%,2 and an incidence ranging from 0.3/1000 in people aged 55-65 years to 4.4/1000 for those aged over 85.3 Most patients live with the disease for many years because the risk of death is increased only modestly in the absence of dementia4 but the burden of disease on patients and carers is considerable. A survey among US veterans showed that health related quality of life was substantially diminished among patients with Parkinson’s disease and that the impact of the disease outweighed that of other chronic disorders such as coronary heart disease, arthritis, diabetes, or stroke.5

Before the introduction of ParkinsonNet in the Netherlands in 2004, feedback from focus groups and online patient forums suggested that Dutch patients with Parkinson’s disease were dissatisfied with their care.6 7 They complained that treatment tended to be exclusively focused on suppression of symptoms with drugs (and sometimes stereotactic neurosurgery) and that referral to other …

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