Descriptive study of general practitioner's practices and knowledge about Parkinson's disease in the north of France

Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and constitutes a significant public health challenge [1]. In 2015, 166,712 individuals in France received treatment for PD, resulting in a prevalence of 2.50 per 1000 people across all age groups [2]. Within the same year, 25,842 individuals were newly treated, resulting in an incidence of 0.39 per 1000 person-years. With as the population ages, it is expected that the number of individuals with PD will double by 2030 [2], [3]. The high prevalence of PD and its impact on quality-of-life of patients and caregivers has led to the implementation of a “Parkinson plan” in France in 2012, aimed at improving care organization. Part of this plan involved the creation of French “Parkinson Expert Centers” (PDECs). These centers must meet specific criteria ensuring that they possess leading expertise in France for managing patients with PD. Subsequently, PD was included alongside Alzheimer's disease and multiple sclerosis in the “Neurodegenerative Disease Plan 2014–2019”. The objective of this plan was to enhance patient care, support, and research for these diseases [4]. In line with these initiatives, the French National Authority for Health published guidelines for general practitioners (GPs) in 2012, with revised versions in 2016, outlining the care pathway for Parkinsonian patients [5]. GPs play a central role in the French healthcare system, serving as the initial point of contact for the diagnosis and management of chronic diseases such as PD. It is well known however that PD can be difficult to diagnose because classic symptoms such as rigidity and tremor are not always present and may be preceded by a variety of motor and non-motor symptoms that are not necessarily disease-specific [1], [6], [7]. When patients consult their GP, symptoms are often still limited and embedded in clinical uncertainty. As a consequence, the pathway to confirmed diagnosis of PD can be lengthy and uncertain, which, unless well explained, could be reasonably expected to have a negative influence on patient confidence, trust, and satisfaction [8], [9]. Only a limited number of studies have explored how GPs manage PD in their clinics and whether they consult or communicate with neurologists regarding treatment plans for these patients [10], [11], [12], [13]. Studies have shown that PD patients who received neurologist care had improved survival demonstrated by higher survival rates and an increase in the odds of survival compared with primary care physician–treated subjects [14]. Consequently, it is important to identify the difficulties GPs encounter when caring for PD patients in order to help them better close the gaps in care strategies. We thus conducted a descriptive cross-sectional survey in Picardy, a region in northern France, to evaluate GP practices and knowledge about PD and their accordance with care pathway recommendations. Our study aimed to assess current GP practices of GPs for the diagnosis and management of PD. This included GPs’ level of confidence, adherence to the French National Authority for Health guidelines, and ongoing training needs.

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