质量测量帕金森病的依从性：单中心经验***帕金森病质量测量

IF 1.8 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders Pub Date : 2025-01-01 DOI:10.1016/j.prdoa.2025.100337

Tanner Bradford , Bryanna De Lima , Kahley Milauskas , Mary Brooks , Suvi Neukam , Lee E. Neilson

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引用次数: 0

摘要

背景：帕金森病（PWPs）患者通常有运动和非运动表现，需要专门的护理。神经科医生通常领导他们的护理；然而，残疾人士的人数超过了神经科医生的人数。初级保健提供者（pcp）可能需要为改善护理做出贡献。目的衡量神经科医生和pcp对PWPs的依从性。方法我们进行了一项单中心回顾性描述性分析，评估了过去一年中由神经科医生和PCP建立的pwp的14个QMs。McNemar的测试评估了各组之间的统计差异。Logistic回归模型探讨了年龄、性别和就诊频次对质量管理依从性的影响。结果89名护理人员平均解决了8.9个质量管理问题。运动并发症、康复转诊、跌倒和自主神经功能障碍是最常见的，而冷漠和冲动控制障碍是最少的。单独的神经科医生比单独的pcp更容易出现运动并发症、精神病、冲动控制障碍和睡眠障碍，而pcp更经常评估抑郁症和提前护理计划。PCP治疗改善了患者的整体依从性。年龄和/或就诊频率显著影响抑郁、冷漠和提前护理计划指标依从性。结论以团队为基础的质量指标依从性方法可以减轻医疗服务提供者的负担，改善护理质量。

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Quality Measure Adherence in Parkinson’s Disease: A Single Center Experience***Parkinson’s Disease Quality Measures

Background

Patients with Parkinson’s Disease (PWPs) often have both motor and non-motor manifestations requiring specialized care. Neurologists typically lead their care; however, the population of PWPs is exceeding the supply of neurologists. Primary care providers (PCPs) may need to contribute to improve care.

Objective

To measure American Academy of Neurology quality metric (QM) adherence between neurologists and PCPs for PWPs.

Methods

We conducted a single-center retrospective, descriptive analysis assessing 14 QMs in the past year for PWPs established with a neurologist and PCP. McNemar’s test assessed statistical differences between groups. Logistic regression models explored the impact of age, sex, and visit frequency on QM adherence

Results

On average, 8.9 QMs were addressed among 89 PWPs. Motor complications, rehabilitation referrals, falls, and autonomic dysfunction were the most often addressed while apathy and impulse control disorder were the least. Neurologists alone met motor complications, psychosis, impulse control disorder, and sleep disturbance significantly more than PCPs alone while PCPs assessed depression and advance care planning more often. PCP involvement improved adherence throughout. Depression, apathy, and advance care planning metric adherence were significantly impacted by age and/or visit frequency.