Abstract

We must urgently allocate more resources to upskilling general practitioners to better diagnose and manage Parkinson disease, particularly in regional areas, writes Dr Shanna Fealy.

Parkinson disease is the second most prevalent neurodegenerative disease globally, trailing only Alzheimer disease. In 2014, Parkinson’s Australia commissioned Deloitte Access Economics to develop an updated report on living with Parkinson disease in Australia. The report estimated that over 200 000 Australians are currently living with Parkinson disease, imposing a substantial economic burden upwards of $9.9 billion. Alarmingly, the economic burden of disease on the Australian health care system is set to increase, with an estimated 36% rise in Parkinson disease prevalence by 2024 and a staggering 79% increase by 2034, largely attributed to an ageing population.

For people living with Parkinson disease outside of metropolitan areas, access to specialist Parkinson disease care is inequitable (here). Last year, the World Health Organization’s technical brief, Parkinson disease: a public health approach, emphasised that an urgent response incorporating interdisciplinary care involving general practitioners (GPs), specialist neurologists, specialist neurological nursing and allied health care services is required.

The problem is that implementing such a team approach is challenging within regional and rural areas, as specialist neurological health services are concentrated in major metropolitan centres, resulting in the burden of diagnosis and treatment falling on GPs. Although GPs are well placed to diagnose and treat Parkinson disease, the complexity of disease pathology, in particular subtle early non-motor symptoms (here), is often linked to other causes (such as ageing), delaying diagnosis particularly for those living in regional and rural areas.

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