Parkinson's disease: national clincial guideline for management in primary and secondary care

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Developed by the National Collaborating Centre for Chronic Conditions at the Royal College of Physicians, published June 2006 (review date October 2016)

This comprehensive evidence-based guideline provides best practice guidance on the diagnosis and management of Parkinson's disease (PD). It also highlights seven key priorities for implementation to help providers of care and commissioners of service to target critically important aspects of PD. These will benefit a large number of people with PD and make a sizable difference to the care these people receive. They focus on:

  • referral to an expert for accurate diagnosis
  • regular review of the PD diagnosis
  • palliative care

Details are provided of the systematic reviews of the PD evidence base, health economic modelling and the considerations from the Guideline Development Group. The evidence base is systematically reviewed and recommendations are provided for:

  • diagnosing PD
  • neuroprotection
  • symptomatic pharmacological therapy (which for ease of use is divided into early and later PD) including comparisons of drug classes
  • surgery for PD
  • the management of non-motor features
  • specialist care
  • palliative care

User-friendly tables are given for options for initial pharmacotherapy in early PD and adjuvant pharmacotherapy in later PD, together with an algorithm for everyday practice use and areas for clinical audit. Importantly, the guideline also provides recommendations for future research that will enable researchers, R&D funders and ethics committees to streamline research developments and activities.

The guideline is intended to inform the practice of general practitioners, neurologists, specialist physicians, specialist PD nurses and specialist therapists. It is available to download in full as a pdf.


  • The development
  • Introduction
  • Methodology
  • The guideline
  • Key messages
  • Communication with people with PD and their carers
  • Diagnosing PD
  • Neuroprotection
  • Symptomatic pharmacological therapy in PD
  • Surgery for PD
  • Non-motor features of PD
  • Other key interventions
  • Palliative care in PD
  • Research recommendations
  • References

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