Date Published: 5 July 2006

Study finds hospital admissions for Parkinson's patients often avoidable

A new Australian study has found that 39% of patients with Parkinson's disease are admitted to hospital with complications related to having Parkinson's such as falls and dementia. Adequate community support and medical advice could have prevented hospital admission. The study by Associate Professor James Temlett and Professor Philip Thompson is in the latest edition of the Internal Medicine Journal (IMJ), the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP).

" The management of Parkinson's disease tends to focus on the presenting motor syndrome, yet in the long term, non motor complications of the illness and complications of treatment become increasingly troublesome. With disease progression, additional problems emerge including medication side effects, alterations in cognition and behaviour and responsive motor problems," A/Prof Temlett said.

The study looked at patients admitted to Royal Adelaide Hospital in 1999, 2002 and 2004. During this time 761 patients were admitted with Parkinson's disease.

The results found only 15% of patients were admitted for primary management of the motor syndrome. Parkinson's disease was the secondary diagnosis in 645 admissions. Of these 39% were admitted because of falls leading to fracture, pneumonia, encephalopathy or dementia and hypotension with syncope. Cardiac and gastrointestinal diseases accounted for a further 22%.

" We found complications of the later stages of Parkinson's disease and associated treatments are more likely to lead to hospital admission than management of the primary motor syndrome. Accordingly, at least 30% of hospital admissions may be avoidable through early intervention and better planning of management in the outpatient and community setting," A/Prof Temlett said.

" Some of these admissions may be potentially avoidable. Non-motor syndromes, if identified early enough could be managed in the community or home setting. Acute brain syndromes and postural hypotension are likely to result from the adverse effects of medication and drug interactions and therefore may be avoidable with close monitoring. Falls, fractures and other injuries may be minimized by utilizing protective devices in those at risk of falls. Even simple measures such as the early recognition and outpatient management of constipation could reduce the need for emergency admissions."

According to its website at the time of publication of this article the RACP is responsible for training, educating and representing over 9,000 physicians in Australia and New Zealand. The RACP represents 25 medical sub-specialties including paediatrics, public health and occupational medicine. Physicians are often called specialists and are doctors who have completed an extra six years or more of training after their initial medical training and choose to specialise in a particular area of medicine.

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