Searching for a needle in a haystack-ambulatory research in Parkinson's disease in Germany

Parkinson's disease (PD) is a prevalent neurodegenerative disorder with a rapidly increasing incidence worldwide and complex treatment requirements. It is predominantly treated on an outpatient basis. However, detailed clinical data from outpatient practice remain scarce. We therefore set out to evaluate PD care practices in the outpatient setting. As preliminary work for a pilot project, this report represents the first systematic exploratory survey to assess outpatient treatment patterns in Germany. The aim of this survey is to document the current outpatient treatment approaches for PD, to identify potential gaps in the existing clinical guidelines, and to highlight the lack of outpatient-specific evidence.

A cross-sectional baseline survey was conducted online using a standardized questionnaire among neurologically specialized outpatient practices in Germany. Serving as a baseline assessment of the regional status quo of current care practices, the survey forms the foundation for the subsequent multicenter pilot study AmParkReg, into which these results will later be integrated.

The survey revealed a high degree of homogeneity in routine clinical assessments across various practice types with an emphasis on psychomotor examination, particularly rigidity assessment, reflecting established dopaminergic treatment monitoring. However, the integration of non-motor symptom assessment and comprehensive multimodal diagnostics remains limited. Time constraints and regional variations in practice warrant further investigation. Methodological limitations include regional sampling bias and the lack of temporal data.

These findings underscore the urgent need for ambulatory-specific, evidence-based care standards in PD. The development of longitudinal, multisectoral studies and the strengthening of ambulatory care guidelines are critical for optimizing patient outcomes. This work provides foundational data to refine ambulatory management and fosters the integration of precision approaches into routine PD care in Germany.