by Dr Chineze Ivenso
About 130,000 people have a diagnosis of Parkinson’s disease in the UK (PD UK 2012), and in a 10 year period about 80% may develop dementia (Movement Disorder, 2007). About 100,000 people are thought to suffer from Lewy Body Dementia in the UK (Lewy Body Society 2010).
The aim of this audit was to ascertain whether the assessment and management of patients with Parkinson’s disease dementia/dementia with Lewy bodies (PDD/DLB) meets the standards within the NICE guidelines for dementia. Documentation within case notes was analysed within the memory service in Newport Older Adult team and results disseminated to look at ways of improving the service following audit.
Fifteen cases were audited (9 female, 6 male, 63-86 years) from the Memory Assessment Clinic in Newport Older Adult services. These patients had been seen within the team in the last 12 months. Data was collected by the audit lead via the analysis of case notes in relation to referral, diagnosis, types of assessment carried out, tests at time of presentation, information given to family following diagnosis, patient documentation and medication.
Types of assessment:
Relevant standards are the NICE Guidelines for Dementia and NICE Guidelines for Parkinson’s disease. There is no specific guidance on the treatment of dementia for Parkinson’s disease patients.
Overall there was a high level of compliance with the standards. Tests at the time of presentation were not undertaken in all cases. Midstream urine testing was undertaken in only 27% of cases.
It is important to ensure that the high level of compliance continues. Recommendations include ensuring that there is a midstream urine test in all cases in order to rule out urinary tract infection or delirium. Findings should be shared with the Newport team and with the Older Adult teams across ABUHB mental health services. We recommend audits are undertaken in all teams to compare data and share good practice.