Improving Screening for Sleep Disturbance in Patients with Parkinson’s Disease

Abstract

Background: Sleep disturbance (SD) is one of the most common and debilitating non-motor manifestations of Parkinson’s disease (PD). SD intensifies the disease-related disabilities of motor and non-motor symptoms. In spite of this, it is often under-recognized and underaddressed by healthcare professionals. The Movement Disorder Society recommends the Parkinson’s disease Sleep Scale (PDSS – 2) be used to screen and measure severity of overall sleep problems in this patient population. Objectives: The purpose of this quality improvement (QI) project is to increase the utilization of the PDSS-2, a standardized approach to assessment of sleep difficulties. This can facilitate identification of individual SD to target treatment appropriately. There are two aims: 1) to improve the screening rate of SD in patients with PD to 80%, and 2), to assess for association between the screening and treatment planning. Methods: Using the PDCA study design, the PDSS -2 sleep screening questionnaire were distributed to every returning patient over three cycles. Results: We recruited 41 patients. The screening rate improved from 51.2% at the pretest to 82.9% at the posttest, reaching the goal of 80%. The change in the rate of treatment planning from pretest to posttest is from 52.5% to 31.7 % (p = 0.03). The use of PDSS – 2 did reduced the rate of treatment planning for sleep. Conclusions: This QI project positively increased the rate of sleep screening in at risk patients with PD. An improvement in the rate of screening and pretest treatment reduced the rate of treatment planning at the follow up visit

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