Evidence-Based Taiwan Consensus Recommendations for the treatment of Parkinson's disease

Abstract

Parkinson's disease (PD) is a common and disabling neurodegenerative disorder with a prevalence set to double by 2030. People with PD present both motor symptoms (such as tremor, rigidity, slowness of movements, and postural instability) and non-motor symptoms (such as dementia, psychiatric symptoms, and sleep disturbances). The treatment of PD is challenging and is highly individualized. The Taiwan Movement Disorder Society (TMDS) has published its treatment recommendations for PD in 2017. Since then, because the advent of medical and device-aided therapy has developed rapidly, the TMDS has recognized the need to disseminate the updated knowledge about the management of PD. The TMDS acknowledges the importance of evidence-based medicine (EBM) in clinical practice. Therefore, we strive to align our treatment recommendations with EBM principles. Nevertheless, it still needs to be emphasized that therapeutic recommendations should always be tailored to the individual patient, based not only on an accurate understanding of the efficacy and side effect profile of available treatments (the primary focus of guidelines), but also the physician's judgment, patient's preference, and the regulations of national health insurance. To ensure that the updated Taiwan treatment suggestions are appropriate and feasible, the treatment guideline subcommittee of TMDS referred to the guidelines from the International Movement Disorder Society and other treatment suggestions from United States and Europe concerning the level of evidence, recommendation levels, clinical efficacy, and potential adverse reactions of therapeutics for the treatment of motor and non-motor symptoms of PD. By incorporating the latest research, international guidelines, and treatment suggestions, the TMDS aims to provide comprehensive and up-to-date recommendations for the management of PD in Taiwan. These recommendations serve as a valuable resource for healthcare professionals to enhance their understanding of PD treatment options and optimize patient care. Key Words: Parkinson's disease; treatment; guidelines; evidence-based medicine.