The Parkinson’s Academy draws on a team of expert professionals with a rich blend of skills in treating and managing patients with Parkinson’s.
Many of our speakers have a background in both clinical and research work, and so bring to bear both their practical experience as well as their knowledge about the evidence base for managing Parkinson’s.
With speakers from a wide range of areas, such as psychiatry, palliative care, and deep brain stimulation, the Masterclasses provide broad training for any professional with an interest in honing their Parkinson’s knowledge and skills. The Advanced Masterclass (previously known as the classic) also has a focus on service development, and our presenting clinicians share their own frank experiences of setting up a local Parkinson’s service.
Sessions are delivered in groups of between 20 and 30, with a relaxed atmosphere and plenty of opportunity for questions and discussion. Speakers make particular use of video and case histories to enable delegates to explore advanced questions about Parkinson’s care.
Click on the videos below to discover what the Academy has to offer in more detail.
Pathology, anatomy, genetics & neurophysiology
Parkinson’s disease is not just about the motor syndrome, says Dr Paul Worth – the non-motor symptoms often develop well before the onset of motor symptoms. This is important because not only does that help with diagnostic certainty but also may help us in future to identify patients who are at risk of developing Parkinson’s.
Patients often ask whether Parkinson’s is genetic and Paul’s stock response is “no” – it is not genetic, with the caveat that there are rare families where Parkinson’s can be inherited. However, for the vast majority of people there are genetic factors that can influence the risk of developing Parkinson’s but which do not determine it per se.
Building a service
Dr Neil Archibald draws on his experience of setting up and delivering a Parkinson’s service in Teesside to share his successes and pitfalls with people embarking on the same process themselves.
Neil’s talk covers how important it is to consider the local incidence and prevalence of Parkinson’s in your area, how to use data to your advantage, secure financial support, and tap into the pool of talent that is available to you.
In his talk on differential diagnosis in Parkinson’s disease, Dr Paul Worth underlines the importance of always asking whether a patient’s symptoms are consistent with Parkinson’s.
Using videos and case histories Paul looks at conditions like multiple systems atrophy, progressive supranuclear palsy and vascular parkinsonism, and highlights what some of the diagnostic ‘red flags’ are when reviewing patients.
Early treatment options
Dr Neil Archibald discusses early treatment options in Parkinson’s, covering what drugs are available, when to start them, who to start them on, and what to tell patients.
With an emphasis on the multidisciplinary team approach, which is particularly important for newly diagnosed patients, Neil moves onto the evidence base for Parkinson’s treatments and practical advice for a busy clinic, as well as looking at the controversial topic of when to introduce Levodopa.
The patient perspective
Something that comes across time and time again when talking to people with Parkinson’s is the importance of getting it right when you deliver a diagnosis to a patient. Many patients speak about feelings of shock and bereavement when they find out they have Parkinson’s and this can take a long time to recover from.
A sense of hope is really important and this can be supported by providing the right information, which covers what the condition is and who they can get in touch with. Richard also touches on the importance of signposting people to reliable sources of information, particularly given that internet searches can bring up sites advertising untested treatments.
The multidisciplinary team
A really good Parkinson’s service involves a really good multidisciplinary team of allied health professionals, explains Dr Richard Genever, and importantly a Parkinson’s nurse specialist who can be invaluable to patients by providing expert and responsive care.
Proactive care from the whole team early on is essential to help support patients to avoid crisis points later on and to give them a point of reference if any problems do crop up.
Complex case histories
Dr Peter Fletcher and Dr Robin Fackrell run an interactive session at the Parkinson’s Masterclass covering a number of complex case histories.
Robin says the main learning points include taking things back to basics by saying what you can see and challenging yourself at every step along the diagnostic pathway, as well as thinking about how you might investigate, and what questions you are trying to answer if you choose to have a scan for example. Often clinicians are not expecting a second diagnosis to occur, but Robin says they must keep antennae up for other things going on, especially as patients get older
The practical side of cognitive & psychiatric aspects
Prof Iracema Leroi speaks to Masterclass delegates about the cognitive and psychiatric aspects of Parkinson’s which is important now that people are living longer with the condition. She covers mild cognitive impairment and dementia in Parkinson’s, as well as psychosis, depression and anxiety, plus impulse control disorders.
Iracema is keen for delegates to understand the interaction between the motor symptoms and the cognitive impairment and psychiatric symptoms of Parkinson’s. She discusses the importance of apathy, an under recognised symptom and potential predictor for dementia in Parkinson’s. Both apathy and dementia must be identified and managed because they have a significant impact on patients’ quality of life.
Case histories on cognitive & psychiatric aspects
Dr Iracema Leroi addresses the cognitive and psychiatric aspects of Parkinson’s disease through an interactive case study session. Her first case study involves how to manage mild cognitive impairment, which is quite common and may indicate later development of dementia in Parkinson’s. Iracema then moves on to psychosis and dementia in late stage Parkinson’s, addressing diagnosis and acute and long-term management.
She also breaks down the elements of apathy – an under recognised issue in Parkinson’s, especially as cognitive impairment worsens – and how this can be managed. Finally Iracema talks about impulse control disorders, covering both the risk factors for developing this problem and how to manage it.
Non-motor issues in Parkinson’s
The motor features of Parkinson’s have traditionally been the focus of management, but Dr Robin Fackrell argues that in fact non-motor symptoms such as sleep disturbance, constipation and dementia detract from quality of life the most in PD. Robin focuses on identifying these challenging symptoms and managing them effectively.
“As the going gets rough” – drug management in complex disease
Dr Richard Davenport talks about the drug management of complex Parkinson’s disease. He emphasises that the motor aspects of Parkinson’s are only part of the condition, and in fact for many patients the non-motor symptoms influence quality of life the most.
The currently available complex therapies are largely targeting the motor components of the condition. Richard uses case histories to help discuss how you identify suitable patients for individual therapies and how you manage expectations for patients who will not be suitable for therapy.
Commissioning Parkinson’s services in the new NHS
Sue presents at the Parkinson’s Masterclass on service development, including current policy and how that affects services and looking at data – both interpreting it and using it as a lever for service change. All of this helps support clinicians to make a business case and liaise with NHS commissioners effectively.
Sue emphasises that the key to developing a good service for Parkinson’s patients is baseline analysis. This means assessing what works well, and what doesn’t work so well in the patient journey, so that you can create a service that responds to patient needs and which is efficient too. The benefits of getting this right include avoiding costly preventable hospital admissions and improved patient experiences.
Identification and management of PSP and MSA
Dr Boyd Ghosh speaks to delegates about multiple systems atrophy (MSA) and supranuclear palsy (PSP) which are atypical parkinsonian syndromes that are fairly difficult to diagnose in the early stages.
Boyd shows delegates videos of patients so that they can learn to recognise how MSA and PSP are different from Parkinson’s disease. For example patients with PSP do not have Levodopa responsiveness or may be sensitive to light, which is a sign that it not always readily recognised.
Managing complex and palliative care issues
Dr Ed Richfield talks about the transition from complex to palliative care in Parkinson’s disease. He addresses the evidence for palliative care need as well as service provision, and moves onto some case histories.
One patient for example was in the early stages of Parkinson’s and not particularly badly affected by the condition yet but had some specific fears about losing his independence and capacity to make decisions. Ed feels that over the coming years we will see more services that are designed to respond to these type of identify palliative care needs wherever they exists in the disease course.
Surgical procedures: selection, suitability and practical aspects
Lucy Mooney is a lead movement disorder nurse specialist who addresses the important topic of deep brain stimulation (DBS) in Parkinson’s.
She covers the basics of DBS, what types of symptoms will respond to it, and when is the best time to refer patients. Lucy shows delegates videos of patients who are on and off stimulation, as well as discussing the follow-up care and management of DBS patients.
Emerging and current treatment evidence
Dr Alison Yarnall talks at the Masterclass about emerging and current evidence for the management of motor symptoms in Parkinson’s such as dyskinesias and motor fluctuations, as well as looking at non-motor symptoms.
Alison covers drugs that may soon be coming to the market, as well as effective non-pharmacological interventions such as strength and balance training for reducing falls. Where it comes to neuropsychiatric symptoms, there is a current lack of treatment for dementia in Parkinson’s although there are promising new treatments for psychosis.