2024 年 41 巻 1 号 p. 19-23
With levodopa and many other replacement therapies, the quality of life of patients with Parkinson disease offers significant advantages over other neurodegenerative diseases. However, as the disease progresses, wearing–off and dyskinesia occur more frequently, and the patient's QOL gradually declines ; as QOL declines, it becomes difficult to ensure the patient's quality of life even with the best drug choices. Therefore, it is important to collaborate with community medical services such as home–visit medical care, home nursing care, and nursing homes. In the past, the term “collaboration” has often referred to bridging to the community and then leaving it up to the community. In this manuscript, I will report on our experience of regional collaboration at the Department of Neurology, Osaka University School of Medicine. In particular, I believe that the key point is how to ensure the quality of medical care for Parkinson disease patients in cooperation with the local community while enhancing the nursing support established by the local community. We believe that the role of core hospitals in the future will be to move away from hospital–based Parkinson disease care, which has focused on drug selection, to comprehensive PD care in the community from a broad perspective, including nursing care, rehabilitation, nutritional management, home modification, and facility enrichment.
