Approximately one million Americans currently live with Parkinson’s Disease with 60,000 new cases diagnosed each year. Common symptoms of resting tremors, slowness of movement and rigidity appear in geriatric patients for a variety of reasons and as there is no definitive diagnostic test, the misdiagnosis rate of Parkinson’s is strikingly high, around 25 percent. To combat this issue, the National Parkinson’s Foundation (NPF) has been advocating for an increase in research, patient care resources and training in diagnosis and care for physicians and pharmacists.
“There is a large need for pharmacists who understand not only Parkinson’s, but geriatrics in general,” said associate professor Charles Mosler, Pharm.D. For the spring 2018 semester, Mosler will be introducing a course focusing on issues affecting Parkinson’s patients. Findlay students currently take Parkinson’s classes as part of the required coursework. This elective will cover nuances such as the sleep disorders and patient self-care that accompany the disease.
As a pharmacist working in geriatrics for the past 15 years, Mosler’s experience with Parkinson’s led him to accept a traineeship with the American Society of Consulting Pharmacists (ASCP). Mosler and three practicing pharmacists attended a four-day course held at Northwestern University Parkinson’s Disease and Movement Disorders Center (MDC). Recognized by the NPF as a Center for Excellence and by the National Institutes of Health as a Morris K. Udall Center for Parkinson’s Research, the MDC utilizes patient interactions and experts in the field to teach a better understanding of the diagnosis process and needs of Parkinson’s patients.
“My favorite part of the traineeship was being in the same room as a patient and being able to see how the neurologist approached them and to see how the physical assessment of a Parkinson’s patient is done,” said Mosler. Pharmacists provide a bridge between the scientific and personal aspect of medicine. Learning how to approach patients appropriately and develop relationships are important parts of effective pharmaceutical treatment.
The traineeship classes were taught by experts in side effects common to Parkinson’s, such as a speech pathologist and a sleep-specialty doctor. “One thing that pharmacists can really impact is the non-prescription drugs,” explained Mosler. “Dry mouth, dry eyes, constipation and sleep disturbances are all side effects of Parkinson’s treatment which require separate medications you have to balance. For example, most Parkinson’s medication drops blood pressure too low, so if the patient is on blood pressure medicine, you need to know how to adjust that and advise your patient to look out for things like getting dizzy.”
While the majority of the MDC patients had Parkinson’s, there were patients with diseases visually similar to Parkinson’s, like benign tremors and supranuclear palsy. “If most people saw these diseases side-by-side they wouldn’t be able to tell much of a difference. But they are treated differently, so it’s important to be diagnosed correctly to get the right treatment,” said Mosler. The Parkinson’s patients in the MDC varied from people who were being told they had Parkinson’s for the first time to people who had been living with it for 20 years.
The traineeship was led by MDC Director Tanya Simuni, M.D., the lead and principal investigator in a number of clinical trials on the management of Parkinson’s Disease. “She organized and arranged everything for the traineeship,” said Mosler. “She is well known and respected in the field. Being able to work with people who are extremely knowledgeable in this field was the most influential part of the traineeship.”
Mosler hopes to pass onto his students the importance of personalized patient care and the in-depth knowledge it takes to effectively treat Parkinson’s. “If we can teach students to be more understanding of Parkinson’s and the intricacies of it, then that will pave the way to better care for Parkinson’s patients in the future.”