by Dr Ban Al-Saffar
In this pilot audit a questionnaire was sent to FY2 doctors from different specialties. The doctors were randomly selected, with a 100% rate (7/7) and anonymised responses.
The questions and answers given were:
- How many patients with PD managed? – Average: 10 patients. Range: 2-15. Two doctors only seen 2 patients.
- How confident are you in managing PD? – 5/7 ‘little confident’. 2/7 ‘not confident’.
- Features of PD – All new cardinal features
- Non-motor symptoms – 2/7 Depression. 5/7 Dementia.
- Treatment options available – All new L-Dopa/Sinemet. No other drugs known.
- Side effects of treatment – 1/7 knew majority of SEs. 6/7 stated rare effects.
- Treatment options for NBM PD patients – 0/7 knew answer.
- Anti-emetics to avoid in PD patients – 6/7 answered correctly. 1/7 answered cyclizine.
- Awareness of local PD guidelines – 0% aware of local PD guidelines
- Conditions mimicking PD – 3/7 aware of common conditions. 2/7 BET. 2/7 blank.
Overall there was fair exposure but little confidence. The junior doctors surveyed had weak knowledge of non-motor symptoms, limited knowledge about drug treatment and side effects. None knew what to do when patient NBM and none were aware of local PD guidelines
The knowledge and awareness in handling PD patients needs to improve amongst junior doctors (especially management). Recommendations are to include PD in mandatory teaching, ensure more exposure to case studies and videos, and clinic/ward based teaching.
2016 update: I have included PD teaching by a nurse specialist and a consultant in foundation mandatory teaching in their first term at work. We need to audit and re-audit before and after teaching. However, there has been an observed improvement in management of PD inpatients. Almost all get reviewed by a PDNS on admission. We have PD clinics that trainees of all levels are invited to attend. The teaching is been done on a yearly cycle as foundation doctors change every year.