Article

In the absence of specific clinical signs, imaging or biomarkers,
the differential diagnosis of degenerative parkinsonian syndromes may be
difficult at early stages of the disease. To reduce the risk of misdiagnosis or
delayed diagnosis and referral to multiple medical centers at disease onset,
easier access to expert centers should be available.
To improve the initial care
of parkinsonian patients, the Parkinson's disease Expert Center (PEC) at
Pitie-Salpetriere Academic Hospital has set up a specific outpatients clinic with
short waiting times dedicated to the diagnosis of early Parkinson's disease and
related disorders. METHODS: The PEC setup first identifies requests for
diagnostic confirmation of parkinsonian syndromes, then specific outpatients
clinic visits are scheduled weekly, with examinations carried out by neurologists
at the PEC on a rotating schedule. Data from the first year of the new procedure
were analyzed retrospectively through self-administered questionnaires sent to
patients seen during this period. The main outcomes were to confirm the ability
to keep to short delays for patients' examinations and to assess patients'
satisfaction with the setup. RESULTS: Both study outcomes were achieved. The
creation of an outpatients clinic dedicated to the early diagnosis of
parkinsonian syndromes allowed shorter delays before the first examination of 5
weeks instead of several months. Keeping to the weekly schedule and limited time
taken for each visit was also achieved. Following this initial outpatients visit,
diagnosis of a parkinsonian syndrome was clinically confirmed or further
specified in 80% of cases.
A survey of patients' satisfaction showed a rate of
over 91% in terms of the timing and course of clinical examinations at our PEC.
CONCLUSION: This study of our quality-improvement program for
Parkinson's disease management has shown that specific consultations with shorter
waiting times aiming to allow early specialized assessment of parkinsonian
syndromes is beneficial for patients and reduces the risk of delayed diagnoses.
CI - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS