Integrated palliative care service for Parkinson’s disease in the UK: impact on place of death

OBJECTIVES: Patients with advanced Parkinson's disease and related disorders (PDRD) experience significant symptom burden, yet access to specialist palliative care (SPC) is often limited. The Bristol service uses existing resources to form a multidisciplinary meeting (MDM) attended by both movement disorders and palliative care specialists. This integrates primary and SPC and allows sharing of expertise to holistically address unmet palliative care needs. Here, we evaluate this model. METHODS: We conducted a retrospective review of case notes of patients discussed in the Parkinson's Disease Palliative Care MDM between February 2020 and April 2025. RESULTS: Of 106 patients (mean age 77.3 years), 87% were referred by the specialist movement disorders team. The primary reasons for referral included symptom control (74%) and emotional/psychological support (43%). Almost two-thirds (64%) were not previously known to hospice services. During follow-up, 66% of patients died, with a median time to death of 118 days (-10 to 1182). These occurred most commonly at home (43%) or in nursing homes (40%), with few hospital deaths (13%). CONCLUSIONS: An integrated palliative care service for those with PDRD is sustainable, improves access for groups otherwise unknown to SPC services and may facilitate preferred place of death and reduce hospitalisation at end of life. This requires further evaluation.