# Holistic Care Clinic for People with Parkinson’s Disease: Outcome from a Newly Developed Service

## TL;DR

A new holistic care clinic for Parkinson’s patients focusing on non-motor symptoms like anxiety improved patient outcomes and satisfaction.

## Contribution

A novel multidisciplinary clinic addressing non-motor symptoms in Parkinson’s disease with measurable clinical and patient-reported improvements.

## Key findings

- 62% of patients showed improvement in clinical outcomes using the CGI scale.
- Psychoeducation for anxiety had a 91% recommendation rate from participants.
- Cardiac biofeedback significantly reduced anxiety scores (p = 0.03) with high patient satisfaction.

## Abstract

Background/Objectives: Non-motor symptoms (NMS) in Parkinson’s disease (PD), particularly neuropsychiatric disturbances such as anxiety, significantly impact quality of life. The Holistic Care Clinic for Parkinson’s disease at St George’s Hospital offers multidisciplinary assessments and personalized care to address both motor and non-motor symptoms, aiming to improve patient well-being and empower patients to manage their health and enhance their quality of life. This study evaluated the effectiveness of a holistic management approach for PD patients with prominent non-motor symptoms, particularly neuropsychiatric issues, by analyzing clinical outcomes and patient feedback. Methods: A retrospective analysis was conducted on patients referred to the clinic between June 2022 and June 2023 for non-motor symptoms. Patients received comprehensive assessments, including clinical exams and interviews focused on neuropsychiatric symptoms, followed by individualized care plans. Interventions for anxiety included online psychoeducation and cardiac biofeedback. Outcomes were assessed using the Clinical Global Impression (CGI) scale and patient feedback on interventions. Results: Thirty patients (mean age 65.7 years, mean disease duration 7.8 years) were included. Anxiety was the primary referral reason (66%). CGI scores indicated that 62% of patients experienced improvement. Medications were adjusted in 14 patients and 65% improved. For anxiety, 13 patients attended the psychoeducation session, with 91% rating it “very likely”/”likely” to recommend. Ten patients completed cardiac biofeedback training, showing a significant reduction in Parkinson’s Anxiety Scale scores (p = 0.03), and 90% recommending it. Conclusions: The holistic care approach of PD patients resulted in significant improvements in clinical outcomes. Patient feedback indicates high satisfaction with the interventions, supporting their acceptability and overall satisfaction with the interventions.