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NICE: Adults with Parkinson’s should be referred to OT services

NICE quality standard states that occupational therapy can play a key role in supporting adults with Parkinson’s disease

Published on 26th February 2018

Adults with Parkinson’s disease should be referred to occupational therapy services, the National Institute for Health and Care Excellence has stated.

A NICE quality standard on Parkinson’s disease recommends that adults with Parkinson's disease are referred to physiotherapy, occupational therapy or speech and language therapy if they have problems with balance, motor function, activities of daily living, communication, swallowing or saliva.

“Adults with Parkinson's disease may experience a wide range of symptoms. Physiotherapy, occupational therapy and speech and language therapy can help people to manage their symptoms, maintain their independence and avoid hospital admission. After a referral to therapy services, it is important to ensure that therapists are included as part of the person's multidisciplinary team,” said the quality standard.

Service providers should ensure that adults with Parkinson's disease have regular assessments of balance, motor function, activities of daily living, communication, swallowing and saliva. If problems are identified they are referred for physiotherapy, occupational therapy or speech and language therapy specific for Parkinson's disease.

Healthcare professionals such as neurologists, elderly care consultants, Parkinson's disease nurse specialists and GPs need to be aware of local referral pathways to physiotherapy, occupational therapy and speech and language therapy for adults with Parkinson's disease. Healthcare professionals should carry out regular assessments of balance, motor function, activities of daily living, communication, swallowing and saliva for adults with Parkinson's disease and refer them for physiotherapy, occupational therapy or speech and language therapy specific for Parkinson's disease if problems are identified.

Commissioners such as CCGs should commission physiotherapy, occupational therapy, and speech and language therapy specific for adults with Parkinson's disease and ensure that referral pathways are in place.

As a result, adults with Parkinson's disease should referred to a physiotherapist for specialist treatment if they have problems with movement or balance. They should be referred to an occupational therapist if they have difficulties with everyday activities such as dressing, cooking and working, and to a speech and language therapist if they have speech problems or problems with swallowing or drooling.

The quality standard should ensure that the health-related quality of life for adults with Parkinson's disease improves. Hospital admission rate for falls among adults with Parkinson's disease should reduce as should hospital admission rate for aspiration pneumonia among adults with Parkinson's disease.

The Royal College of Occupational Therapists has welcomed the quality standard. Dr Jenny Preston, Chair, Royal College of Occupational Therapists Specialist Section Neurological Practice said: “The Royal College of Occupational Therapists Specialist Section Neurological Practice welcomes these new NICE quality standards for adults with Parkinson’s disease. The standards recognise the benefits that occupational therapy can bring to adults with long term degenerative diseases, and that the ability to take part in activities of daily living is a vital element of quality care for these individuals. We have adopted the NICE 2017 guidelines within our own practice guide for occupational therapists working with adults with Parkinson’s disease, and look forward to sharing this updated resource with members in the immediate future.”

The five quality standard contained in the document are:

Statement 1 Adults with Parkinson's disease have a point of contact with specialist services.

Statement 2 Adults with Parkinson's disease taking dopaminergic therapy are given information about the risk of impulse control disorders, when starting treatment and at least annually.

Statement 3 Adults with Parkinson's disease are referred to physiotherapy, occupational therapy or speech and language therapy if they have problems with balance, motor function, activities of daily living, communication, swallowing or saliva.

Statement 4 Adults with Parkinson's disease who are in hospital or a care home take levodopa within 30 minutes of their individually prescribed administration time.

Statement 5 Services for adults with Parkinson's disease provide access to clozapine and patient monitoring for treating hallucinations and delusions.

NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a prioritised set of specific, concise and measurable statements.

The NICE quality standard on Parkinson’s disease is available here.

 

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