A systematic review of interventions to reduce hospitalisation in Parkinson's disease

The neurodegenerative process in Parkinson's disease (PD) results in a relentless progression of motor and non-motor symptoms. Affected individuals are frequently hospitalised for complications of the disease including falls, fractures, infections, and neuropsychiatric symptoms. When admitted to hospital, inpatient care is often suboptimal as it focusses on the primary cause of admission, and is associated with poor patient outcomes and significant healthcare costs. Aim: To review existing literature for evidence-based interventions aimed at reducing hospital admissions in PD. Methods: Electronic literature search in EMBASE, MEDLINE and CINAHL databases for studies evaluating interventions to reduce hospital admissions in PD. We included publications with full abstracts, published in the English language and addressing interventions to reduce hospital admissions in PD. Results: To date there are no randomised controlled trials addressing the topic. We identified nine relevant retrospective studies. Results from these studies suggest an association between frequent neurologist consultations, open access clinics, and medication compliance with a reduction in PD hospital admissions and emergency room visits. Conclusion: This systematic review highlights the lack of robust evidence for measures aimed at reducing hospital admissions in people with PD. Future prospective studies are required to evaluate the effectiveness of proposed interventions. (C) 2016 Elsevier Ltd. All rights reserved.