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Planned, structured education, delivered by nurses, can help people with Parkinson's disease to manage their medications - and thus their symptoms - more effectively. This article describes how such education sessions should be packaged
Key words
Parkinson's disease
Drug therapy
Education
Multidisciplinary teams
These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.
Parkinson's disease (PD) is a progressive neurodegenerative disease affecting an estimated 78,000 Australians (Doherty et al 2004). PD manifests as symptoms that adversely affect movement and the ability to perform self-care activities. In the later stages of the disease cognition is often impaired. There is disruption to many aspects of everyday living, resulting in increased burden on family, partners and healthcare providers (lansek 1999).
PD is known to be caused by depletion of dopamine-producing neurons within the substantia nigra of the midbrain. The reason for dopamine depletion and cell destruction is the focus of much research, but risk factors and direct causation remain unknown (Morns et al 1997, Goldsmith 1999, Waters 1999, Olanow et al 2001, Sethi 2002, Tinter et al 2002). PD is more commonly diagnosed in the older age group - those over 70 years of age - but it is also clinically diagnosed in younger people in the third or fourth decade of life.
Today dopamine replacement in the form of medication is standard treatment for PD symptom control. Surgical techniques, such as deep brain stimulation, have also proved to be effective in some PD patients.
The challenge for people with PD and their healthcare providers, if medications are required for PD symptom control, is to ensure optimal medication treatment. Medication use that is supported by movement, speech and swallowing strategies is regarded as the gold standard of PD treatment (lanek 1999, Olanow et al 2001, Sunvisson et al 2001). PD is not a curable disorder and treatment is aimed at symptom control. Therefore the focus of treatment should be on maintaining a sense of quality of life for the person with PD.
Educating the person with PD about the use and side-effect profile of medications is one strategy that can be used to assist in maintaining quality of life. The specialist nurse has the...