Objective: To assess deficiencies in patient care for individuals with Parkinson’s disease in neurology clinics, with a particular focus on nonmotor symptoms.

Background: While motor symptoms are the hallmark of Parkinson’s disease (PD), non-motor symptoms (NMS) significantly impact patients’ quality of life, but are often underrecognized and inadequately addressed in clinical practice. These symptoms include neuropsychiatric disturbances, sleep disorders, autonomic dysfunction, and sensory abnormalities. This study aims to assess patients’ perspectives on the prevalence, severity, and clinical management of NMS at a tertiary neurology center.

Method: A quality improvement (QI) initiative was conducted at the University of Utah Department of Neurology to evaluate patient-reported experiences with NMS. A survey was disseminated via the Parkinson’s Center of Excellence listserv, collecting data on symptom prevalence, impact, and the frequency with which these concerns were addressed during neurology visits.

Results: Sixty-two patients (mean age = 71.3, SD = 7.9 years) completed the pre-intervention survey. The most frequently reported NMS were fatigue (83.9%), gastrointestinal dysfunction (72.6%), sleep disturbances (66.1%), anxiety (61.3%), and depression (56.5%). Approximately 22.6% of patients reported that NMS always affected daily life, and 46.8% stated they often had an impact. While 71% of patients reported being screened for NMS at least often, 29% indicated inconsistent screening. Similarly, while 66.2% of patients felt their symptoms were often or always addressed, 33.8% expressed that their concerns were only sometimes or rarely acknowledged. Qualitative responses highlighted a desire for structured symptom screening, improved provider awareness, and comprehensive symptom management strategies.

Conclusion: Patients with PD frequently experience NMS, which are not consistently addressed in clinical encounters. Implementing structured pre-visit symptom screening tools may enhance provider-patient communication, increase symptom recognition, and improve management. In the next phase of this project, we will implement an in-clinic screening survey to enhance provider awareness and guide discussions during consultations. Ongoing analysis of post-intervention data will assess the effectiveness of this initiative in optimizing the care of PD patients and ensuring a more comprehensive approach to their treatment.

NMS Response Rate

NMS Screening Results

NMS Addressed in Clinic

Proposed survey of NMS in Clinic

References: Onder H, Comoglu S. Prevalence and clinical correlates of nonmotor symptoms in Parkinson’s disease in a tertiary health-care center in Turkey. Neurol Res. 2024 Nov;46(11):1054-1062. doi: 10.1080/01616412.2024.2381162. Epub 2024 Aug 28. PMID: 39193879.

Hou, J. G., & Lai, E. C. (2007). Non-motor symptoms of Parkinson’s disease. International Journal of Gerontology, 1(2), 53–64. https://doi.org/10.1016/s1873-9598(08)70024-3

Chaudhuri KR, Schrag A, Weintraub D, Rizos A, Rodriguez-Blazquez C, Mamikonyan E, Martinez-Martin P. The movement disorder society nonmotor rating scale: Initial validation study. Mov Disord. 2020 Jan;35(1):116-133. doi: 10.1002/mds.27862. Epub 2019 Sep 30. Erratum in: Mov Disord. 2020 Oct;35(10):1892. doi: 10.1002/mds.28266. PMID: 31571279; PMCID: PMC7037759.

Li, X., Chen, C., Pan, T., Zhou, X., Sun, X., Zhang, Z., Wu, D., & Chen, X. (2024). Trends and hotspots in non-motor symptoms of Parkinson’s disease: a 10-year bibliometric analysis. Frontiers in Aging Neuroscience, 16. https://doi.org/10.3389/fnagi.2024.1335550

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patients-perspective-on-screening-for-non-motor-symptoms-in-parkinsons-disease-a-qi-project/