'De-novo' consultation: Evaluation of an outpatient's clinic dedicated to early diagnosis of parkinsonian syndromes

Autor: Andreas Hartmann, Cécile Hubsch, David Grabli, Louise-Laure Mariani, Pauline Dodet, Jean-Christophe Corvol, Marie Vidailhet, Yulia Worbe, S. Aix, J. Ruggeri, Florence Cormier, A. M. Bonnet, Emmanuel Roze, Marie-Laure Welter, Bertrand Degos, Lucette Lacomblez
Přispěvatelé: Service de Neuroradiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre expert inter-régional de coordination de la maladie de Parkinson [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Service de neuropédiatrie et maladies métaboliques [CHU Robert-Debré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), HAL-UPMC, Gestionnaire
Rok vydání: 2017
Předmět:
Adult
Male
Pediatrics
medicine.medical_specialty
Parkinson's disease
Referral
Disease
Ambulatory Care Facilities
Parkinsonian syndrome
Young Adult
03 medical and health sciences
0302 clinical medicine
Parkinsonian Disorders
Outpatients
medicine
Humans
[SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
Expert center
Young adult
Medical diagnosis
Disease management (health)
Referral and Consultation
Aged
Retrospective Studies
Aged
80 and over
business.industry
Retrospective cohort study
Middle Aged
Early diagnosis
medicine.disease
3. Good health
Patient care management
Neurology
030220 oncology & carcinogenesis
Physical therapy
Female
[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
France
Neurology (clinical)
Differential diagnosis
business
030217 neurology & neurosurgery
Zdroj: Revue Neurologique
Revue Neurologique, Elsevier Masson, 2017, 173 (1-2), pp.55-61. ⟨10.1016/j.neurol.2016.12.031⟩
Revue Neurologique, 2017, 173 (1-2), pp.55-61. ⟨10.1016/j.neurol.2016.12.031⟩
ISSN: 0035-3787
DOI: 10.1016/j.neurol.2016.12.031
Popis: International audience; In the absence of specific clinical signs, imaging or biomarkers, the differential diagnosis of degenerative parkinsonian syndromes may be difficult at early stages of the disease. To reduce the risk of misdiagnosis or delayed diagnosis and referral to multiple medical centers at disease onset, easier access to expert centers should be available. To improve the initial care of parkinsonian patients, the Parkinson's disease Expert Center (PEC) at Pitié-Salpêtrière Academic Hospital has set up a specific outpatients clinic with short waiting times dedicated to the diagnosis of early Parkinson's disease and related disorders.MethodsThe PEC setup first identifies requests for diagnostic confirmation of parkinsonian syndromes, then specific outpatients clinic visits are scheduled weekly, with examinations carried out by neurologists at the PEC on a rotating schedule. Data from the first year of the new procedure were analyzed retrospectively through self-administered questionnaires sent to patients seen during this period. The main outcomes were to confirm the ability to keep to short delays for patients’ examinations and to assess patients’ satisfaction with the setup.ResultsBoth study outcomes were achieved. The creation of an outpatients clinic dedicated to the early diagnosis of parkinsonian syndromes allowed shorter delays before the first examination of 5 weeks instead of several months. Keeping to the weekly schedule and limited time taken for each visit was also achieved. Following this initial outpatients visit, diagnosis of a parkinsonian syndrome was clinically confirmed or further specified in 80% of cases. A survey of patients’ satisfaction showed a rate of over 91% in terms of the timing and course of clinical examinations at our PEC.Discussion/ConclusionThis study of our quality-improvement program for Parkinson's disease management has shown that specific consultations with shorter waiting times aiming to allow early specialized assessment of parkinsonian syndromes is beneficial for patients and reduces the risk of delayed diagnoses.
Databáze: OpenAIRE
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