neurology
2018 NICE Guidelines
for Parkinson’s disease
Clinicians will be trying to adhere to the updated NICE guidelines, but what are the implications
for commissioners and providers of services for people with Parkinson’s disease?
Richard Grünewald
MA DPhil FRCP
Consultant Neurologist
and Clinical Director of
Neurosciences, Sheffield
Teaching Hospitals
NHS Foundation
Trust; Department
of Neurology, Royal
Hallamshire Hospital, UK
In July 2017, The National Institute of Health
and Care Excellence (NICE) published revised
guidelines for Parkinson’s disease in adults. 1
Clinicians will be trying to adhere to these, but
what are the implications of these guidelines
for commissioners and providers of services for
people with Parkinson’s disease?
Parkinson’s disease is a progressive
degenerative disorder, and one of the more
common neurological conditions, with an annual
incidence in the UK of 15–20 per 100,000 and a
prevalence of 1 in 625 of the adult population. 2
Patients with the condition become progressively
disabled by a combination of movement problems
(mainly slowness and difficulty initiating
movement), and non-motor symptoms such as
mental disturbances, autonomic disturbance
4
HHE 2018 | hospitalhealthcare.com
(for example, involving sweating, salivation,
swallowing and digestion, sexual function,
micturition and blood pressure control), cognitive
failure and pain. Ultimately the condition
becomes dominated by symptoms that respond
poorly to medical management, and palliative
care is required.
Management of Parkinson’s disease is
therefore complex and can be resource intensive.
Secondary care services are usually involved early,
either Neurology or Care of the Elderly,
depending on age, co-morbidity of the patient and
local provision. Without effective care systems,
the burden of care on family and carers can be
intolerable, and the use of emergency care
disproportionate. Patients and their carers need
effective means of communication with the