To effectively monitor the progression of Parkinson's disease during routine follow-up visits, ensure that patients have a comprehensive review of all aspects of their care at least every 6 to 12 months, including reassessment of diagnosis if atypical clinical features develop. This review should be conducted by a specialist in movement disorders or a multidisciplinary team including a Parkinson's disease nurse specialist, physiotherapist, and occupational therapist who can advise on motor and non-motor symptom management.
During these visits, assess motor symptoms and complications such as motor fluctuations, dyskinesia, freezing of gait, and falls, and check adherence to anti-parkinsonian medication including correct doses and timings. Non-motor symptoms should also be actively monitored as they significantly impact quality of life and may require targeted intervention.
Review medication effects and side effects, and liaise with specialists before altering therapy, especially if motor complications persist. Offer referrals to allied health professionals as needed for speech, physiotherapy, occupational therapy, dietetics, and mental health support.
Advise patients and carers about sources of information and support, and discuss advance care planning and palliative care options as appropriate. Also, remind patients who drive to inform the DVLA and their insurer about their condition.