Disparities in neurological management for Parkinson’s disease in Latvia: Pilot study evidence

Parkinson’s Disease management requires coordinated specialist, pharmacological, and non-pharmacological care. In Latvia, regional variation has not been empirically examined. To evaluate regional variation in Parkinson’s Disease management in Latvia from patient and neurologist perspectives and identify system-level barriers to equitable care. A cross-sectional pilot online survey targeted adults living in Latvia with a diagnosis of Parkinson’s Disease (n=50) and licensed neurologists who treat Parkinson’s Disease (n=55). Regional variation was tested using chi-square tests for categorical outcomes and Kruskal-Wallis tests for ordinal outcomes. Patients outside Riga reported longer travel distances (p=0.03), greater difficulty attending appointments (p=0.03), and fewer multidisciplinary care opportunities (p<0.01). The majority used levodopa-based regimens (86%), but reimbursement levels differed regionally (p=0.03). Neurologists most frequently reported limited access to advanced therapies (78.2%), physiotherapy and related services (65.5%), long waiting times (60.0%), and insufficient funding (60.0%) as systemic barriers. Significant regional variation was observed in waiting times (p<0.01), access to advanced therapies (p<0.01), and awareness of national guidelines (p=0.02). Both groups reported the need for improved reimbursement, telemedicine, and expanded regional services. Patients prioritized accessibility and rehabilitation frequency, while neurologists prioritized systemic reforms and training. Regional and systemic disparities persist in Latvian Parkinson’s Disease care, affecting access, funding, and non-pharmacological support. Updating national guidelines, strengthening multidisciplinary networks, expanding reimbursement, and supporting telemedicine and primary care education could promote more equitable, patient-centered management nationwide.