Experts push for ways to expand Parkinson’s specialist care
Healthcare inequities will worsen without immediate action, researchers say
A new study suggests that simple, targeted strategies, from using telehealth to standardizing patient referrals, could help more people with Parkinson’s disease get the specialized care they urgently need. With U.S. cases expected to double by 2040, researchers warn that existing healthcare inequities will worsen without immediate action.
“Research has shown that disparities in access to care have existed, but there hasn’t been as much work done on figuring out solutions,” Sana Aslam, the study’s first author and an assistant professor of neurology at the University of Colorado School of Medicine, said in a university news story. “It’s time to start thinking about collecting real world data and designing interventions that are going to be helpful.”
Policy strategies could address barriers to care
Aslam and her colleagues suggested policy strategies could address barriers to care, allowing more people with Parkinson’s to get treatment.
The researchers’ findings and recommendations were described in a perspective article, which is like a scientific editorial with research backing by experts in the field. The study, titled “The future of Parkinson’s care: a need to expand access,” was published in the journal Frontiers in Neurology.
Parkinson’s is a progressive neurodegenerative disease often characterized by motor symptoms, including tremor and slowed movement. An estimated one million people in the U.S. have Parkinson’s, and this number has been growing in recent decades. Although there isn’t yet a cure, several treatment options can help ease motor symptoms. These include advanced therapies such as deep brain stimulation.
Access to movement disorder specialists and clinics is important for people with Parkinson’s to get the care they need.
“Movement disorder clinics can offer advanced therapies and surgical interventions,” Aslam said. “They can also offer expertise in new medications, keep up with evolving guidelines and regulations about exercise and facilitate participation in clinical trials.”
However, there is a shortage of neurologists, including movement disorder specialists, in the U.S. Previous research suggests that many states require at least 20% more neurologists to meet demand. Because of this, many people with Parkinson’s receive care from primary care providers.
Although primary care providers are a logical first point of contact, the researchers argued that people with suspected Parkinson’s or other movement disorders should consistently be referred to specialists.
“Without a structured, standardized referral system, many [Parkinson’s] patients will continue to experience fragmented care, resulting in poorer outcomes and increased healthcare costs,” the researchers wrote.
Using predefined metrics, such as disease state measurements or medication needs, to consistently trigger specialist referrals could help mitigate this issue, the team suggested.
Another major barrier to specialist access is geography, because most movement disorder clinics are in urban areas. A 2023 study found there were 660 movement disorder specialists in the U.S., with six focused on serving rural communities.
Telemedicine, monitoring technology could improve access
Increasing the use of telemedicine would help people from a broader range of geographical backgrounds access specialist care, according to the researchers. Increasing the use of new monitoring technology, like wearable sensors and smartphone-based assessments, could help augment video conferences with physicians.
There are also other systemic barriers to Parkinson’s care, including concerns about treatment cost and insurance. “These burdens disproportionately affect patients from historically underserved communities, compounding existing health disparities,” the team wrote.
Broad policy reforms will likely be needed to improve the healthcare system’s ability to support the needs of patients from many backgrounds. However, smaller, targeted changes could also make a difference in this area, the researchers noted. For example, Medicaid reimbursement policies could cover more Parkinson’s care options, such as remote health and advanced therapies.
In addition, the team advocated for community engagement and education efforts. By educating both providers and patients about the early signs of Parkinson’s, these efforts could shorten diagnostic delays. They could also help people with Parkinson’s and caregivers better understand therapeutic options.
The researchers concluded that access to specialist Parkinson’s care is an urgent problem requiring immediate and long-term solutions.
“Collaboration among healthcare professionals, advocacy organizations, and policymakers is essential to dismantling barriers to specialist care,” they wrote. “By acting now, we can build a more accessible, equitable, and effective care system for all individuals living with not just [Parkinson’s disease], but other neurodegenerative diseases as well.”
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