CHALLENGES IN PARKINSON’S DISEASE MANAGEMENT IN PRIMARY CARE IN INDONESIA: A NARRATIVE REVIEW
Abstract
Parkinson's disease (PD) is a rapidly growing neurological disorder with significant health implications, especially in low- and middle-income countries (LMICs) like Indonesia. This review analyzed the challenges and opportunities for managing PD in Indonesian primary care. The prevalence of PD in Indonesia has surged by 143% since 1990, reaching 89.91 per 100,000 people in 2019, which is likely underestimated owing to healthcare system limitations. Primary care is critical for early PD detection, although diagnostic accuracy is a concern. Enhancing the primary care capacity for early identification is essential through specialized training, telemedicine, and PD-specific assessment tools. Continuous monitoring of medication adherence, treatment efficacy, and symptom progression is vital for its effective management. Integrating palliative care principles and supporting caregivers is crucial for providing comprehensive care. This review recommends a structured approach to PD management in Indonesia, incorporating it into chronic disease programs, improving diagnostic tools, and developing caregiver support systems to address the growing PD burden and optimize patient outcomes in resource-limited settings.
References
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Bloem, B. R., Okubadejo, N., Okun, M. S., Darweesh, S. K. L., Andrejack, J., Munneke, M., Dorsey, E. R., Henderson, E. J., & Chan, P. (2020). Integrated and patient-centred management of Parkinson’s disease: a network model for reshaping chronic neurological care. The Lancet Neurology, 19(7), 623–634. https://doi.org/10.1016/s1474-4422(20)30064-8
Boersma, I., Jones, J., Coughlan, C., Kutner, J., Kluger, B., Carter, J., Miyasaki, J., & Bekelman, D. (2017). Palliative Care and Parkinson’s Disease: Caregiver Perspectives. Journal of Palliative Medicine, 20(9), 930–938. https://doi.org/10.1089/jpm.2016.0325
Boone, A. E., Henderson, W., & Hunter, E. G. (2021). Role of Occupational Therapy in Facilitating Participation Among Caregivers of People With Parkinson’s Disease: A Systematic Review. The American Journal of Occupational Therapy, 75(3). https://doi.org/10.5014/ajot.2021.046284
Carroll, V., Rossiter, R., & Blanchard, D. (2021). Non-motor symptoms of Parkinson’s disease. Australian Journal of General Practice, 50(11), 812–817. https://doi.org/10.31128/ajgp-07-21-6093
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Connor, K. I., Siebens, H. C., Lee, M. L., Vickrey, B. G., Connor, M. K., Cheng, E. M., Mittman, B. S., Mcgowan, M. G., Barry, F., Edwards, L. K., & Ganz, D. A. (2019). Randomized trial of care management to improve Parkinson disease care quality. Neurology, 92(16), e1831–e1842. https://doi.org/10.1212/wnl.0000000000007324
Dröschel, D., Wilpshaar, G., Lynch, P., & Walzer, S. (2017). How medical technology can support health care management – Introduction of a telemedicine-based integrated care management, for improved diagnosis and treatment in Parkinson’s disease through intersectoral and interdisciplinary collaboration. International Journal of Integrated Care, 17(5), 425. https://doi.org/10.5334/ijic.3744
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Hallett, M., & Hess, C. W. (2017). The Phenomenology of Parkinson’s Disease. Seminars in Neurology, 37(2), 109–117. https://doi.org/10.1055/s-0037-1601869
Hustad, E., Hveem, K., Skogholt, A. H., & Aasly, J. O. (2018). The accuracy of the clinical diagnosis of Parkinson disease. The HUNT study. Journal of Neurology, 265(9), 2120–2124. https://doi.org/10.1007/s00415-018-8969-6
Kanellos, F. S., Tsamis, K. I., Rigas, G., Simos, Y. V., Katsenos, A. P., Kartsakalis, G., Fotiadis, D. I., Vezyraki, P., Peschos, D., & Konitsiotis, S. (2023). Clinical Evaluation in Parkinson’s Disease: Is the Golden Standard Shiny Enough? Sensors (Basel, Switzerland), 23(8), 3807. https://doi.org/10.3390/s23083807
Katz, M. (2020). Palliative Care for Parkinson’s Spectrum Disorders: an Emerging Approach. Neurotherapeutics, 17(4), 1456–1463. https://doi.org/10.1007/s13311-020-00989-1
Khan, A. Z., Lavu, D., & Neal, R. D. (2023). Parkinson’s disease: a scoping review of the quantitative and qualitative evidence of its diagnostic accuracy in primary care. The British Journal of General Practice : The Journal of the Royal College of General Practitioners, 74(741), e227–e232. https://doi.org/10.3399/bjgp.2023.0409
Kluger, B. M., Kutner, J. S., Friedman, C., Goto, Y., Long, J., Hall, K., Cernik, W., Pantilat, S., Miyasaki, J., Galifianakis, N., Fairclough, D., Khan, R., Sillau, S., & Katz, M. (2020). Comparison of Integrated Outpatient Palliative Care With Standard Care in Patients With Parkinson Disease and Related Disorders. JAMA Neurology, 77(5), 551. https://doi.org/10.1001/jamaneurol.2019.4992Konjevod, M., Sáiz, J., Huerta, J. M., Abilleira, E., Bergareche, A., Amiano, P., Chirlaque, M. D., Ibarluzea, J. M., Ardanaz, E., Barbas, C., Vinagre-Aragón, A., & Erro, M. E. (2022). A Set of Reliable Samples for the Study of Biomarkers for the Early Diagnosis of Parkinson’s Disease. Frontiers in Neurology, 13. https://doi.org/10.3389/fneur.2022.844841
Kulcsarova, K., Skorvanek, M., Postuma, R. B., & Berg, D. (2024). Defining Parkinson’s Disease: Past and Future. Journal of Parkinson’s Disease, 14(s2), S257–S271. https://doi.org/10.3233/jpd-230411
Kusuma, D., Ahsan, A., K Sebayang, S., Ng, N., Kusumawardani, N., & Amir, V. (2019). On the verge of a chronic disease epidemic: comprehensive policies and actions are needed in Indonesia. International Health, 11(6), 422–424. https://doi.org/10.1093/inthealth/ihz025\
Li, X.-N., & Zheng, D. (2022). The Role of the Primary Care Physician in the Management of Parkinson’s Disease Dementia. intechopen. https://doi.org/10.5772/intechopen.101024
Lindvall, S., Azulay, J.-P., Kandukuri, P. L., Odin, P., Chaudhari, V. S., Parra, J. C., Alobaidi, A., Oddsdottir, J., Martinez-Martin, P., Chaudhuri, K. R., Wright, J., Domingos, J., & Yamazaki, T. (2024). Economic Burden of Parkinson’s Disease: A Multinational, Real-World, Cost-of-Illness Study. Drugs - Real World Outcomes, 11(1), 1–11. https://doi.org/10.1007/s40801-023-00410-1
Makanjuola, A. I., Ogunniyi, A., Yaria, J. O., Akinyemi, R. O., & Taiwo, F. T. (2021). Parkinson’s disease – a review of pathogenesis, recent advances in management, and challenges of care in sub-Saharan Africa. Journal of Global Medicine, e35. https://doi.org/10.51496/jogm.v1.35
Martinez-Martin, P., Luquin, M.-R., Kulisevsky, J., Mir, P., Tolosa, E., & García-Delgado, P. (2018). Validation of a simple screening tool for early diagnosis of advanced Parkinson\u2019s disease in daily practice: the CDEPA questionnaire. Npj Parkinson’s Disease, 4(1). https://doi.org/10.1038/s41531-018-0056-2
Murtagh, S., Harrold, Á., Casey, M., Broughan, J., Fawsitt, R., Carroll, Á., Dennehy, T., Cullen, W., & Mccombe, G. (2021). Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review. International Journal of Integrated Care, 21(1). https://doi.org/10.5334/ijic.5508
Nelson, G., Christofides, N., Faust, I., Ndlovu, N., Hlungwani, T. M., & Racette, B. A. (2020). Validation of Parkinson’s Disease-Related Questionnaires in South Africa. Parkinson’s Disease, 2020(21), 1–9. https://doi.org/10.1155/2020/7542138
Orban, E., & Şipoş, R. S. (2021). Monitoring the patient with Parkinson’s disease – interdisciplinary challenge. Medic.Ro, 5(143), 8. https://doi.org/10.26416/med.143.5.2021.5505
Ou, Z., Pan, J., Nong, H., Yu, D., Duan, D., Wang, Z., & Tang, S. (2021). Global Trends in the Incidence, Prevalence, and Years Lived With Disability of Parkinson’s Disease in 204 Countries/Territories From 1990 to 2019. Frontiers in Public Health, 9(Suppl 1). https://doi.org/10.3389/fpubh.2021.776847
Oung, Q. W., Basah, S. N., Hariharan, M., Lee, H. L., Yaacob, S., & Sarillee, M. (2014). Use of technological tools for Parkinson’s disease early detection: A review. 343–348. https://doi.org/10.1109/iccsce.2014.7072742
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Published
2024-11-23
How to Cite
RAHMAWATI, Fitriana; MULYANTO, Joko.
CHALLENGES IN PARKINSON’S DISEASE MANAGEMENT IN PRIMARY CARE IN INDONESIA: A NARRATIVE REVIEW.
Mandala Of Health, [S.l.], v. 18, n. 1, p. 06-15, nov. 2024.
ISSN 2615-6954.
Available at: <https://jos.unsoed.ac.id/index.php/mandala/article/view/13791>. Date accessed: 19 apr. 2025.
doi: https://doi.org/10.20884/1.mandala.2025.18.1.13791.
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Articles
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