Parkinson´s day-clinic: which patients should be selected and what services should be offered for successful therapy?

The demographic development and the advance of intensified yet time and personnel-intensive therapeutic options constitute increasing challenges for the care of people with advanced Parkinson's disease (PD). Often, the multitude of motor and non-motor symptoms cannot be adequately addressed in an ambulatory setting The concept of a Parkinson's day clinic has been put forward to meet the requirements for these patients who not necessarily require the full medical support of an inpatient treatment and was included into the Parkinson's guidelines of the German Neurological Society as a novel and promising medical care model. While the guidelines put forward some recommendations as to which patients are most likely to benefit from treatment in a Parkinson's day clinic, it has not yet been decided which infrastructural, operational, personnel and qualitative requirements such a setting should provide. Here we provide recommendations on the basis of an expert consensus as to which patients will particularly benefit from treatment in a Parkinson´s day clinic and which services such a day clinic should address in order to provide successful therapy. Furthermore we suggest a standard operating procedure (SOP) and we give examples of patients who are suitable for treatment in a Parkinson´s day clinic.