Place of Continuous Subcutaneous Infusion Systems in Parkinson Disease Management

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Placement of Infusion Therapies in Parkinson Disease Management

• Consider after oral medication optimization fails to provide adequate control
• Position before deep brain stimulation (DBS) in treatment algorithm
• Appropriate for patients with medication-responsive symptoms but problematic motor fluctuations
• Viable option when cognitive/psychiatric issues contraindicate DBS
• Can be used as a transitional therapy before considering more invasive options
• Particularly valuable for patients with unpredictable off periods
• May be considered earlier in disease course than traditionally recommended for advanced therapies
• Best implemented with a multidisciplinary team approach (neurology, nursing, pharmacy)
• Should be part of a comprehensive care plan addressing motor and nonmotor symptoms