Evaluation of an Interdisciplinary Screening Program for People With Parkinson Disease and Movement Disorders

Abstract

Objective: To describe the characteristics of people with Parkinson disease and movement disorders (PDMDs) referred by neurologist to a physiatrist-led interdisciplinary rehabilitation screening program.

Design: Retrospective data analysis of electronic health records (EMRs).

Setting: Outpatient PDMD neurology clinic and an interdisciplinary rehabilitation hospital's PDMD screening program.

Participants: People with PDMDs referred by neurologists to the interdisciplinary rehabilitation screening program from 2009-2017 (n=934), with early referrals from 2009-2015 (n=449) and recently referred from 2015-2017 (n=485), and patients who had new interdisciplinary rehabilitation screening program evaluations from 2015-2017 (n=183).

Intervention: Participation in the physiatrist-led PDMD screening clinic.

Main outcome measures: Demographics, disease-related features, timed Up and Go, conversational voice volume, recommended therapy services, and number of therapies completed 90 days following interdisciplinary rehabilitation screening program.

Results: People referred from the neurologists to the interdisciplinary rehabilitation screening program from 2009-2017 were 72±12.9 years old, male (56%), white (65%), and with 1 or more comorbidities (62%). Compared with early referrals from 2009-2015, more recently referred participants from 2015-2017 were younger (P<.001) and earlier in disease duration (P=.036). The interdisciplinary rehabilitation screening program participants from 2015-2017 had mean timed Up and Go time of 15.4±10.1 seconds and a mean conversational voice volume of 68.98±4.7 dB.

Conclusions: The interdisciplinary rehabilitation screening program was sustained with increased number of referrals over time, occurring earlier in the disease in more recent years. Key strategies used to sustain the program over time include development of a unique referral order set for the neurologists, implementation of a comprehensive screen tool in the rehabilitation hospital EMR, and centralized communication through social workers at both facilities.

Keywords: EMR, electronic medical record; MD, movement disorder; OT, occupational therapy; PD, Parkinson disease; PT, physical therapy; Parkinson disease; Rehabilitation; SLP, speech language pathology; TUG, timed Up and Go.