Objective: To evaluate and compare clinical practices of providers caring for patients with Parkinson’s disease utilizing searchable proxies of published quality metrics.

Background: In 2020, the American Academy of Neurology (AAN) published a set of Parkinson’s disease (PD) quality metrics in order to improve health care outcomes and standardize practices, partially for payment incentive programs [1].  The measurement set included a total of 10 items including diagnosis review, medication and non-medication based therapies, and evaluation and management of non-motor complications like mood disorders, sleep disturbances, and cognitive impairment. Assessment of adherence to these metrics is challenging, as much of this information is not directly and readily accessible in the EMR without manual chart review.

Method: We first developed proxy measures to approximate the AAN PD quality metrics using discreet data directly available in the EMR, in order to objectively evaluate clinical practices and analyze adherence on a larger scale. We then conducted retrospective analysis of EMR data of patients with PD seen in the last 5 years at the Philadelphia VA and surrounding areas,

investigating rates of adherence to each AAN metric by proxy. Clinical performance indicators such as frequency of follow-up visits, rates of prescribing medications for motor and non-motor symptoms, and utilization of advanced therapies were evaluated.

Results: Data from patients diagnosed with PD were analyzed. These proxy measures allowed for approximation of the application to AAN quality metrics by providers with different training backgrounds.

Conclusion: The AAN PD quality metrics provide a consensus set of measures for quality care in the care of people with Parkinson’s disease, but assessment of adherence to these metrics is challenging to evaluate at a large scale. Proxy measures to approximate these metrics may be an effective way to evaluate quality of care. Further work to enhance adherence and evaluate the relative impact of each metric on patient outcomes is warranted.

References: 1. Chou KL, Martello J, Atem J, et al. Quality Improvement in Neurology: 2020 Parkinson Disease Quality Measurement Set Update. Neurology. 2021;97(5):239-245. doi:10.1212/WNL.0000000000012198

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluating-clinical-practices-of-general-neurologists-and-movement-disorder-specialists-based-on-2020-aan-parkinson-disease-quality-metrics/