title: The role and structure of the multidisciplinary team in the management of advanced Parkinson's disease with a focus on the use of levodopa-carbidopa intestinal gel.
abstract: A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies.
authors.affiliation: Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Copenhagen, Denmark.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Pedersen
authors.affiliation: Department of Neurology, University of Düesseldorf, Düesseldorf, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Suedmeyer
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Toronto, University Health Network, Toronto, ON, Canada.
authors.forename: Louis W C
authors.initials: LW
authors.lastname: Liu
authors.affiliation: Department of Medicine I, Josephs-Hospital Warendorf, Academic Teaching Hospital, University of Muenster, Warendorf, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Domagk
authors.affiliation: PDNS consultant, AbbVie Inc., Roswell, GA, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Forbes
authors.affiliation: Global Medical Affairs, AbbVie Inc., North Chicago, IL, USA.
authors.forename: Lars
authors.initials: L
authors.lastname: Bergmann
authors.affiliation: Global Medical Affairs, AbbVie Inc., North Chicago, IL, USA.
authors.forename: Koray
authors.initials: K
authors.lastname: Onuk
authors.affiliation: Global Medical Affairs, AbbVie Inc., North Chicago, IL, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Yegin
authors.affiliation: Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Teus
authors.initials: T
authors.lastname: van Laar
keywords: Parkinson’s disease; advanced therapy; carbidopa-levodopa enteral suspension; levodopa-carbidopa intestinal gel; multidisciplinary team