P-MD003. Audit of care home residents with parkinsonism in salford

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Introduction . Parkinsonism is common in care home. The prevalence and demographics of care home patients with parkinsonism remains poorly investigated. Previous studies suggested that around 5–7% care home patients have parkinsonism (Susan L. Mitchell MD 1996; Robert J.Buchanana 2002). The 3 year mortality was 50% in care home with parkinsonism (Fernandez HH 2002). Despite that, the diagnosis and management of care home patients with parkinsonism were suboptimum (JP. 1991; Weerkamp NJ 2012; Makoutonina M 2010). Methods . We obtained a list of care home residents with idiopathic Parkinson’s disease, vascular parkinsonism and parkinsonism plus syndrome from community geriatricians in February 2018. Following this, we collected data about patient demographic data, hospital admissions in the last 24 months and advanced care plan using EPR. The data was processed using Microsoft Excel. Results . 56 patients (27 male) with the mean age of 79.89 (SD 8.14) were included in this study. 36 of them also have the diagnosis of dementia. Parkinsonism (Number of patients) Idiopathic parkinson’s disease 31 Vascular parkinsonism 8 Parkinsonism-plus syndrome 11 Drug induced parkinsonism 6 Staging of IPD Stage (Number of patients) Stage 1: 0 Stage 2: 4 Stage 3: 17 Stage 4: 8 Number of medications (Number of patients) 0: 13 1: 32 2: 8 3: 3 Regular physician who reviewed patients Community geriatrician 31 Neurologist 11 Neurolopsychiatrist 5 None 9 34 of them had at least 1 admission in the last 24 months. Reasons for admission (Number of patients) Infection 11 Fall 6 Reduced conscious level 5 4 patients passed away since January 2018. None of them had up-to-date advanced care plan and one of them died in ED after CPR. (Number of patients) Advanced care plan 19 Resuscitation 25 Preferred place of care/death 18 MDT input Number of patients Physiotherapy 14 Occupational therapy 11 Speech and language therapy 19 Dietician 22 Conclusion . The management of care home residents with parkinsonism is suboptimum. We should aim to improve their care in community and hopefully this can reduce unnecessary hospital stay .