MasterClass on the non-oral therapies and new NICE guideline for Parkinson’s

Sarah Gillett, Parkinson’s Academy

July saw the publication of a new NICE guideline for Parkinson’s in adults. The updated guideline NG71 replaces its 2016 predecessor guideline CG35 with new recommendations on treating Parkinson’s disease symptoms, deep brain stimulation, monitoring and managing impulse control disorders, and palliative care.

Central to a good Parkinson’s service is ensuring that all patients received joined-up care. Good communication between clinicians at every point along a patient’s journey is essential, and this includes ensuring that clinicians are confident when it comes to prescribing of and/or referral for the non-oral therapies.

The non-oral therapies for Parkinson’s include: apomorphine, intestinal levodopa gel infusion (Duodopa) and deep brain stimulation. For the right patients, these treatments can be truly life changing.

Most people with Parkinson’s will not need non-oral therapy – for many, tablet and patch medications will manage their symptoms very well. Furthermore, not everyone who is struggling on tablet medications will benefit from non-oral treatments and, of those who try them, not all will tolerate them.

However, for those patients who find their oral treatments are not working well, it’s useful to have the opportunity to have a discussion with a specialist about whether these treatments might have a role.

Last year a best practice pathway for the use of non-oral treatments in Parkinson’s was published, which was devised by clinicians to make the referral process for these therapies more explicit. The tool is an important resource to help clinicians understand the referral criteria and the local process for referral.

Dr Neil Archibald, Consultant Neurologist at James Cook University Hospital, Middlesbrough, Excellence Network Regional Lead for North East and Cumbria and steering group member who helped develop the pathway, said:

“The publication of a detailed pathway for the use of non-oral therapies in Parkinson’s is overdue and incredibly helpful. For too long we’ve been using, or trying to use, these treatments in a rather haphazard fashion. Some patients, in some parts of the country seem to get access and some doctors, in some parts of the country, seem to be unaware of them! What we really need is a “best practice” tool to help inform the management of some of the more complex symptoms of Parkinson’s and now we have one.”

Since the publication of the pathway Parkinson’s Academy has established a regional roadshow on the non-oral therapies. The one-day course called “Making the Most – Non-Oral Therapies in Parkinson’s” is designed to offer practical training to clinicians involved in Parkinson’s care and gives a road-map for the use of non-oral therapies.

The course covers:

  • What non-oral therapies are and how they work
  • What to expect when you make a referral
  • How to use data to convince commissioners
  • Case histories exploring how to use non-oral therapies.

Following the course’s popularity in 2016 and with the publication of the new NICE guideline for Parkinson’s, Parkinson’s Academy is holding an updated 2017 series of regional roadshows which explore the non-oral therapy pathway in detail. The course will address the implications of the 2017 NICE guidelines.

The roadshow dates planned for this year are:

  • Southampton, 16 October 2017
  • Manchester, 20 October 2017
  • Bristol, 6 November 2017
  • Edinburgh, 4 December 2017

To apply for your place, and to access the non-oral therapy pathway, simply visit the Parkinson’s Academy website:

There is no charge for attending this course; however, a fully returnable £50 deposit will be required to secure your place.

For more information contact