New tool helps gauge care for people with neurological disorder

UCLA leads effort to measure care for specialty conditions

A national conversation continues about the best ways to improve both the quality of medical care and to contain costs. So far, developing quality measurements has focused on primary care or highly prevalent, chronic conditions such as asthma and diabetes. But what about brain disorders? To date, the number of measures that apply to neurologic care has been limited.

The American Academy of Neurology (AAN), an association of more than 22,500 neurologists and neuroscience professionals, reached out to a group of neurologists to develop such a set of measurements. Led by Dr. Eric M. Cheng, a UCLA assistant professor of neurology, the group developed a new tool to help doctors gauge how well they are caring for people with Parkinson's disease, a neurological disorder that is estimated to effect nearly 1 million people in the United States. The results are published in today's issue of Neurology, the medical journal of the AAN.

"Measuring the quality of health care is a fundamental step toward improving it," said Cheng, lead author of the study and a clinician with the Veterans Administration Greater Los Angeles Healthcare System. "Quality measures have been developed for conditions seen by primary care doctors for years, but not for many specialty care conditions such as brain disorders."

The AAN has developed measures for stroke and epilepsy and is working on developing similar measures for dementia, neuropathy and multiple sclerosis. The measures for Parkinson's are intended to help doctors determine how well they care for their patients. The group developed 10 separate measures to evaluate care for Parkinson's patients, including non-motor (movement) symptoms, such as depression or sleep, which are strongly associated with quality of life. Another measures the patient's current diagnosis or treatment, while another measures safety, including counseling on preventable complications, such as falls.

"Quality measures like these will be increasingly important for extending the best care possible to people with neurologic disorders like Parkinson's," said Cheng. "But none of these measures prescribe the use of specific medications, assessment tools or treatment options. It was important to leave clinicians with flexibility in how the measures can be successfully completed."