3131 Follow up of housebound and care home patients with Parkinson's disease

Abstract Introduction There are approximately 600 patients in the Pembrokeshire Movement disorder service, of whom, around 10% are either housebound or live in placements. There is concern these patients struggle to access follow up due to difficulties in attending face to face clinics. NICE and Parkinson’s UK recommend that people with Parkinson’s should be seen by a specialist healthcare professional every 6 to 12 months. Method A retrospective case note analysis was carried out for 55 patients that were identified as being either housebound or living in residential or nursing homes. Data were collected on time since last clinic visit and last letter, hospital admissions in the past 2 years, number of prescribed medications and DNACPR status on Welsh Clinical Portal. Results The mean time since last clinic visit was 15.3 months, with the longest 81 months. Housebound patients had a mean time since last clinic visit of 15.5 months and those in placements had a mean time of 15.3 months. The time since last letter was lower, however those patients still in their own homes had a longer interval than those in placement. 53% of patients had a DNACPR decision recorded on Welsh Clinical Portal. When isolating housebound patients this dropped to 29%. 72% of those in placements had a DNACPR decision. Conclusions The requirement to see patients with Parkinson’s every 6 to 12 months is not being met. This is likely due to practical difficulties of attending face to face clinics. It is proposed to create a regular virtual clinic to discuss these patients, in combination with their relatives or carers and patient reported outcome measure questionnaires. This will be brought to the health board Parkinson’s meeting in order to facilitate change. Once the change has been implemented data can be recollected to establish the effect of the change.