Objective: The objective of this project was to determine attitudes toward palliative care (PC) of physicians in the UK who manage movement disorder. Care of the Elderly (COTE) and Neurology teams both manage movement disorder but training and clinics are distinct; a survey was carried out to clarify the opinions of practitioners toward PC. Data was also analysed to see whether there was consensus or differences between the two physician-groups.

Background: Movement disorders such as Parkinson’s disease are life-limiting conditions which affect quality of life and give a high burden of symptoms. PC is an approach to enhance patient management in a holistic way; to improve patient experience. (Miyasaki, 2015)

Methods: An online survey was created and available between March 2016 to June 2017. It was advertised in two speciality periodicals, the British Geriatrics Society Bulletin and the Association of British Neurologists Newsletter. Data was imported into SPSS 24 and analysed in terms of descriptive statistics and differences between groups using chi-squared tests of homogeneity or Fisher’s Exact Test where appropriate.

Results: 52 physicians completed the survey, 28 COTE and 24 Neurologists. All respondents felt that providing PC was within their role. The majority of respondents felt that PC incorporated planning for the future (overall 71%, COTE 58%, Neurology 75%) with no significant differences between groups. Neurologists felt their training was insufficient to provide PC (71% Neurologists compared to 21% COTE) and there were significant differences between the proportions p=<0.0005. In terms of improving PC provision for patients with movement disorder, 71% of Neurologists felt that more training would help compared to 32% of COTE (significant difference between groups, p=0.005). Incorporating MDT clinics with PC specialists was thought to be helpful with 60% overall agreeing that this might facilitate better care with no significant differences between physician groups.

Conclusions: In the UK, a survey of movement disorder physicians showed that all respondents felt that PC was part of their role. The majority of Neurologists did not feel that their training had been adequate and that more might be helpful. It may be that developing Neurology training in the UK to provide more PC might increase confidence to manage movement disorder patients in a holistic way. COTE physicians tended to be more confident in PC; their training may be better suited to cultivating a palliative approach to patients with movement disorder.

References: Miyasaki, J.K., B (2015) ‘Palliative Care for Parkinson’s Disease: Has the Time Come?’, Curr Neurol Neurosci Rep, 15(26).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/attitudes-to-palliative-care-in-movement-disorder-physicians-in-the-uk/