title: Understanding the role of the Parkinson's disease nurse specialist in the delivery of apomorphine therpy.
abstract: Optimal care of Parkinson's disease (PD) patients should involve a multidisciplinary team (MDT) of which a PD nurse specialist (PDNS) is a key member. The role of a PDNS is particularly prominent in the care of advanced PD patients suitable for apomorphine because, in addition to nursing skills, apomorphine treatment requires liaison, training, interaction and coordination with patients, caregivers and other members of the MDT as well as the interface with primary care physicians. The therapeutic success of apomorphine therapy depends not only upon the pharmacologic drug response, but also on how well the patient understands his/her disease and how to handle the therapy. In this respect, a PDNS is a vital member of the MDT who provides education and training, support, and is available for consultation when problems arise. In this article, we review the literature on the contribution of PDNSs in both continuous subcutaneous apomorphine infusion and intermittent subcutaneous apomorphine injection and highlight the various beneficial aspects of PDNS care, supported by scientific evidence when available. Despite a low level of published evidence, there is strong clinical evidence that the impact of PDNSs on the management of apomorphine therapy is vital and indispensable for the success of this treatment.
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org.
authors.forename: Roongroj
authors.initials: R
authors.lastname: Bhidayasiri
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Kamolwan
authors.initials: K
authors.lastname: Boonpang
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Onanong
authors.initials: O
authors.lastname: Jitkritsadakul
authors.affiliation: Pacific Parkinson's Research Center, University of British Columbia, Vancouver, (1982-2007), Canada.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Calne
authors.affiliation: Movement Disorder Clinic, University Hospital of Bispebjerg, Copenhagen, Denmark.
authors.forename: Tove
authors.initials: T
authors.lastname: Henriksen
authors.affiliation: National Parkinson Foundation Centre of Excellence, King's College Hospital, London, United Kingdom.
authors.forename: Sally
authors.initials: S
authors.lastname: Trump
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Suchapit
authors.initials: S
authors.lastname: Chaiwong
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Phenprapa
authors.initials: P
authors.lastname: Susang
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Nonglak
authors.initials: N
authors.lastname: Boonrod
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Jirada
authors.initials: J
authors.lastname: Sringean
authors.affiliation: Department of Neurology, University of Groningen, Groningen, The Netherlands.
authors.forename: Teus
authors.initials: T
authors.lastname: van Laar
authors.affiliation: Department of Neurology, University of Groningen, Groningen, The Netherlands.
authors.forename: Martje
authors.initials: M
authors.lastname: Drent
authors.affiliation: National Parkinson Foundation Centre of Excellence, King's College Hospital, London, United Kingdom.
authors.forename: K Ray
authors.initials: KR
authors.lastname: Chaudhuri
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001058:Apomorphine / Q000627:therapeutic use*; D006801:Humans; D055104:Infusions, Subcutaneous / Q000379:methods / Q000592:standards; D000072184:Nurse Specialists / Q000193:education / Q000592:standards*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000451:nursing*
chemical_list: D000978:Antiparkinson Agents; D001058:Apomorphine
keywords: Apomorphine; Multidisciplinary team; Parkinson's disease; Parkinson's disease specialist nurse