Practices, Resources and Challenges in Parkinson's Disease Management in Asia: Movement Disorders in Asia Study Group Report.

BACKGROUND

The prevalence of Parkinson's disease (PD) is increasing markedly in Asia, highlighting the urgent need to understand the current practices and challenges in delivering comprehensive PD care in this region.

OBJECTIVES

We aimed to determine the resources and facilities for comprehensive management of PD in Asia focusing on regions (South East Asia, Middle East, Indian Subcontinent, East Asia, and Central Asia) and income levels (high-income countries-HIC, upper middle-income countries-UMIC, lower middle-income countries-LMIC).

METHOD: A survey-based questionnaire was deployed to the MDS affiliate societies or key neurologists in 32 countries in Asia.

RESULTS

Thirty countries/territories participated in the survey. HICs have better availability of and accessibility to most health care professionals. Central Asia has the lowest availability of and accessibility to health care professionals. PD nurses are least available (33.3%) and least easily accessible (6.7%). Levodopa and anticholinergics are the most available (100%), accessible (100%) and affordable (100%) antiparkinsonian medications. Device-aid therapies are more available and accessible in East Asian countries/territories, compared to other regions. Accessibility to allied health professionals is poor (43%). Genetic testing is available in 18 (60%) countries/territories, mostly in HIC (P = 0.031). Community engagement and public health awareness campaigns are available in 21 (70%) countries/territories. Brain bank is available in seven (24.1%) countries/territories, mostly in HIC. Telemedicine is utilized in 21 (70%) countries/territories.

CONCLUSION

This is the first survey-based study to highlight regional and income-based disparities on infrastructures required for comprehensive PD care in Asia. Regional collaborations between HIC and MIC may address some of these disparities.