Addressing knowledge gaps in Parkinson’s disease: a report on the Movement Disorder Society’s Centre-to-Centre initiative to improve Parkinson’s disease services in Lao People’s Democratic Republic

Onanong Phokaewvarangkul, Somchit Vorachit, Appasone Phoumindr, Saysavath Keosodsay, Ronald B. Postuma, Wassilios G. Meissner, Roongroj Bhidayasiri
BMC Med Educ. 2020-07-29; 20(1):
DOI: 10.1186/s12909-020-02161-x

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Lao People’s Democratic Republic (Lao PDR) has only nine neurologists for seven million people; none have formal training in Parkinson’s disease (PD). Medical specialists require sufficient PD knowledge to provide high-quality care.

This study outlines a Centre-to-Centre programme for developing PD expertise in underserved regions through a tailored two-year educational enterprise between an established movement disorder mentor centre at Chulalongkorn University in Thailand and mentee centres in Lao PDR. Background knowledge of 80 Laotian physicians was assessed using a validated PD knowledge questionnaire containing 26 questions divided into 3 sections (diagnosis, therapeutic options, disease course) before and immediately after one-day kick-start training. Responses were compared across physicians’ demographic groups.

Of 80 respondents, 50 (62.5%) were board-certified physicians, of which 27 (54%) specialised in internal medicine. Apparent knowledge gaps were shown by a 51.2% correct response rate for total score, 52.8% for diagnosis, 50.6% for therapeutic options, and 48.2% for disease course. No significant differences in total score or any domain sub-scores between neurologists and other specialties were found. Many did not know which non-motor symptoms could occur as prodromal symptoms or late in course of PD. Incorrect responses mainly reflected a lack of knowledge of the impact of medication on disease. Total and domain sub-scores significantly improved after the course (p < 0.05, each). The size of difference of the means was significant for the total score (d = 0.82), therapeutic option (d = 0.56), and disease course (d = 0.68) sub-scores.

Significant improvement of PD knowledge amongst Laotian physicians is demonstrated after a training course, focusing on practical management of PD. Our findings highlight the importance of continued medical education, especially PD-specific training.

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