Objective: The International Parkinson’s Disease Nurse and Advanced Practice Study Group within the International Parkinson’s and Movement Disorder Society conducted this survey to identify current clinical practices, challenges, and knowledge gaps related to management of skin complications in subcutaneous PD infusion therapy. The goal is to inform development of international best-practice recommendations and consensus.

Background: Subcutaneous infusion therapies provide continuous dopaminergic delivery for people with Parkinson’s disease (PD) and are increasingly used worldwide. While these therapies improve symptom control, infusion-site skin complications are common and may affect treatment adherence. Despite the clinical importance of these reactions, standardized guidance for prevention and management remains limited.

Method: An international cross-sectional survey of clinicians experienced in PD device-aided therapies was conducted. Survey domains included clinical experience with infusion-site complications, management strategies, perceived adequacy of available literature, and willingness to participate in consensus guideline development.

Results: At the time of analysis, 21 responses had been collected. Respondents reported frequent encounters with infusion-site reactions such as nodules, irritation, and localized inflammation.

Practice approaches varied considerably. Clinicians reported using multiple strategies including site rotation protocols, massage techniques, topical treatments, and structured patient education to manage or prevent reactions. However, 50% of respondents reported that current literature does not sufficiently guide skin management.

Despite this variability, there was strong interest in collaborative guidance development.

Conclusion: Skin complications remain a common challenge in subcutaneous infusion therapy for PD, with considerable variability in management strategies across clinicians and regions. Early findings highlight significant gaps in evidence-based guidance and underscore the need for internationally informed best-practice recommendations. Ongoing data collection will expand representation across additional regions globally and support development of consensus recommendations aimed at improving patient comfort, treatment adherence, and outcomes in PD infusion therapy management.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/toward-global-best-practices-for-managing-skin-complications-in-subcutaneous-infusion-therapy-for-parkinsons-disease-a-nursing-and-advanced-practice-perspective/