School of Parkinson educational program
Health Problem : Risk of fall
Designation
School of Parkinson therapeutic education program
Abbreviation
TEP-Parkinson
Category
Psychosocial
Main Indication
Reduce the amount of time spent offline each day.
How does it work?
“OFF” refers to periods when the effects of anti-Parkinson's medications wear off and symptoms (bradykinesia, rigidity, tremor) reappear or worsen. These episodes can be predictable (occurring before the next dose) or unpredictable (random OFFs). Common causes include disease progression, the absorption capacity of the active ingredient (levodopa), drug and dietary interactions (high-protein meals), constipation or gastroparesis delaying absorption, and fluctuations related to medication dosing. The School of Parkinson therapeutic education program reduces OFF episodes, and this benefit persists at 3 and 6 months. The NPI improves patients’ and their caregivers’ knowledge, understanding, and coping strategies regarding Parkinson’s disease. It enhances their confidence in decision-making and collaboration with healthcare providers. This leads to a positive attitude and better treatment adherence, which helps stabilize movements and reduce other symptoms associated with the disease.
Other Benefits
- Patient engagement and empowerment.
- Greater knowledge and more appropriate behavior related to the condition, or health literacy.
- Increased medication adherence and compliance.
- Improved independence.
- Improved quality of life.
- Reduced burden on caregivers.
- Fewer falls.
- Positive socioeconomic impact.
Direct Risks
No serious adverse events related to the procedure were reported, but rapid independence can sometimes lead to falls and other relational and psychosocial consequences.
Risks of interaction
None have been reported to date in studies.
Contraindications
Significant cognitive impairment (severe memory problems/significant impairment of executive functions) that limits comprehension, the ability to keep a logbook, and the application of strategies.
Advanced stage of the disease with severely reduced mobility, preventing the performance of practical exercises.
Lack of a dedicated caregiver, preventing daily implementation and travel.
Other severe health issues, particularly cardiovascular and respiratory conditions, increasing risks during sustained physical activity.
Depression, apathy, or low motivation preventing learning.
Logistical (transportation, etc.) or socioeconomic (language, financial resources, access to care, etc.) issues limiting participation and follow-up.
Advanced stage of the disease with severely reduced mobility, preventing the performance of practical exercises.
Lack of a dedicated caregiver, preventing daily implementation and travel.
Other severe health issues, particularly cardiovascular and respiratory conditions, increasing risks during sustained physical activity.
Depression, apathy, or low motivation preventing learning.
Logistical (transportation, etc.) or socioeconomic (language, financial resources, access to care, etc.) issues limiting participation and follow-up.
Duration
6 weeks
Sessions per week
1 supervized session per week
Precautions
Before the session
The practitioner verifies the identities of the patient and the caregiver.
The practitioner obtains informed consent.
The practitioner requests permission to document any incidents.
An emergency contact form (phone number, primary care physician) must be completed.
Monitoring of comorbidities (recent cardiopulmonary evaluation if relevant history, identified contraindications).
The list of treatments will be reviewed by requesting the prescription sheet and any recent changes.
Time will be set aside with the caregiver for further explanation if necessary.
Instructions will be given to the patient and the caregiver before the start of each session.
Sessions will be scheduled during the ON period if possible.
The objective of each session, its duration, and the homework (10 min/day) will be explained.
Warning signs and the immediate stop procedure will be reviewed.
The current status (ON/OFF) will be assessed and noted in the logbook.
Blood pressure and oxygen saturation may be measured if the patient’s history warrants it. **
During the session
The presence of a trained healthcare professional is required during the exercise.
The professional will monitor the patient continuously and watch for signs of fatigue, shortness of breath, pain, dizziness, and low blood pressure.
The exercise must be stopped immediately in the event of dizziness, chest pain, fainting, or a fall.
Record any proposed medication changes and confirm them with the neurologist as needed. In the event of an incident, the primary care physician and the referring neurologist will be notified.
After the session
A review of the exercises and a check to ensure they are understood will be conducted (10 min/day).
Time will be set aside to discuss the session with patients and caregivers to gather feedback, and participation will be noted.
A record of any adverse events will be maintained.
The practitioner verifies the identities of the patient and the caregiver.
The practitioner obtains informed consent.
The practitioner requests permission to document any incidents.
An emergency contact form (phone number, primary care physician) must be completed.
Monitoring of comorbidities (recent cardiopulmonary evaluation if relevant history, identified contraindications).
The list of treatments will be reviewed by requesting the prescription sheet and any recent changes.
Time will be set aside with the caregiver for further explanation if necessary.
Instructions will be given to the patient and the caregiver before the start of each session.
Sessions will be scheduled during the ON period if possible.
The objective of each session, its duration, and the homework (10 min/day) will be explained.
Warning signs and the immediate stop procedure will be reviewed.
The current status (ON/OFF) will be assessed and noted in the logbook.
Blood pressure and oxygen saturation may be measured if the patient’s history warrants it. **
During the session
The presence of a trained healthcare professional is required during the exercise.
The professional will monitor the patient continuously and watch for signs of fatigue, shortness of breath, pain, dizziness, and low blood pressure.
The exercise must be stopped immediately in the event of dizziness, chest pain, fainting, or a fall.
Record any proposed medication changes and confirm them with the neurologist as needed. In the event of an incident, the primary care physician and the referring neurologist will be notified.
After the session
A review of the exercises and a check to ensure they are understood will be conducted (10 min/day).
Time will be set aside to discuss the session with patients and caregivers to gather feedback, and participation will be noted.
A record of any adverse events will be maintained.
Regulatory provisions
By prescription only.
In France, the practitioner must have completed a 40-hour training course in Patient Education (ETP) recognized by a Regional Health Agency.
In France, the practitioner must have completed a 40-hour training course in Patient Education (ETP) recognized by a Regional Health Agency.
Main Initiator
Maria Francesca De Pandis, Rossella Rotondo, Maria Levi Della Vida et Valeria Servodidio, San Raffaele Cassino, Cassino, Italie.
Margherita Torti, Miriam Casali, Laura Vacca, Stefania Proietti, Fabrizio Stocchi, IRCCS San Raffaele Roma, Rome, Italie.
Lanfranco Lodice, Italian Health Ministry c/o USMAF Campania, Naples, Italie Fabio Viselli, San Giovanni Battista Hospital, Rome, Italie.
Margherita Torti, Miriam Casali, Laura Vacca, Stefania Proietti, Fabrizio Stocchi, IRCCS San Raffaele Roma, Rome, Italie.
Lanfranco Lodice, Italian Health Ministry c/o USMAF Campania, Naples, Italie Fabio Viselli, San Giovanni Battista Hospital, Rome, Italie.
Author(s) of the Sheet
NPIS (comité scientifique)
Creation Date : 12/03/2026
Revision Date : 14/04/2026
Version : V01
Revision Date : 14/04/2026
Version : V01
Download the sheet in PDF format
Designation
School of Parkinson therapeutic education program
Abbreviation
TEP-Parkinson
Category
Psychosocial
Main Health benefit
- Reduce the amount of time spent offline each day.
- ICD 11 : 8400.0
Explanation
“OFF” refers to periods when the effects of anti-Parkinson's medications wear off and symptoms (bradykinesia, rigidity, tremor) reappear or worsen. These episodes can be predictable (wearing-off before the next dose) or unpredictable (random OFFs). Common causes include disease progression (decreased dopaminergic reserve), pharmacokinetics (delayed absorption of levodopa), drug and food interactions (high-protein meals), constipation or gastroparesis delaying absorption, and fluctuations related to medication intake. The School of Parkinson therapeutic education program reduces OFF episodes, and this benefit persists at 3 and 6 months (De Pandis 2023). NPI improves patients’ and caregivers’ knowledge, understanding, and coping strategies regarding Parkinson’s disease. It enhances their confidence in decision-making and collaboration with healthcare providers. This results in a positive attitude and improved treatment adherence, which significantly reduces motor fluctuations and non-motor symptoms.
Routine Test
OFF time is typically measured as the daily duration in minutes using a Hauser/PD Home Diary (Hauser 2004; Löhle 2022).
Threshold
60 minutes per day.
Minimal Clinically Important Change
60 minutes per day (a good balance between sensitivity and clinical significance). The validity of the day/night self-assessment diary depends on the patient receiving proper training; without it, variability increases and the sensitivity threshold becomes less reliable.
Secondary benefits
- Patient engagement and empowerment (Kang 2022; Mathur 2024).
- Improved knowledge and more appropriate behavior related to the disease, or health literacy (Kang 2022; Mathur 2024).
- Increased medication adherence and compliance (Grosset 2007; De Pandis 2023).
- Improved autonomy (De Pandis 2023).
- Improved quality of life (Pigott 2022; De Pandis 2023).
- Reduced burden on caregivers (De Pandis 2023).
- Decreased number of falls (De Pandis 2023).
- Positive socioeconomic impact (Wang 2018).
Direct Risks
No serious adverse events related to the procedure were reported, but rapid independence can sometimes lead to falls and other relational and psychosocial consequences.
Risks of interaction
None have been reported to date in studies.
Biological and Psychosocial Mechanisms
Neuroplasticity and cortico-subcortical reorganization
Structured activities stimulate synaptic plasticity and functional connectivity between the motor cortex, cerebellum, and basal ganglia, promoting compensatory pathways for dopaminergic loss. They improve coordination and motor fluency by strengthening complementary circuits.
Sensory-motor coupling and rhythmic cueing
Music and rhythm provide external cues that partially replace the impaired internal clock in people with Parkinson’s disease, facilitating the initiation and continuity of movement and reducing freezing. The expected effect is improved gait rhythm, reduced hesitations, and immediate gains in walking ability.
Improvement of motor function through cardiovascular and muscular training
Regular exercise increases strength, endurance, and muscle plasticity, which reduces fatigue and may lessen the severity of motor symptoms during ON and OFF periods. The expected outcome is a reduction in motor desynchronization, greater functional reserve, and improved exercise tolerance.
Indirect pharmacokinetic optimization
Education regarding diet, constipation, and dosing timing can improve levodopa absorption (shorter absorption time, fewer fluctuations), contributing to the reduction in OFF time observed in educational studies. The expected outcome is a reduction in OFF episodes.
Adherence and treatment management
Structured learning increases understanding of dosing regimens and interactions (food-drug), which improves adherence and consistency of dosing with a decisive impact on OFF time. Patients and their caregivers seek theoretical and practical knowledge (Krieger 2024; Lang 2025).
Self-efficacy, motivation, and repetition
Programs build self-efficacy, encourage daily practice and the integration of exercises, which prolongs motor and non-motor benefits (Amstrong 2021). The expected outcome is the maintenance of beneficial behaviors over the long term.
Social and emotional effects
Group participation reduces isolation, improves mood and resilience, reduces the burden on caregivers, and increases adherence to recommendations (social reinforcement) all factors correlated with a better quality of life and sustainable functional gains. The patient takes ownership of their condition.
Structured activities stimulate synaptic plasticity and functional connectivity between the motor cortex, cerebellum, and basal ganglia, promoting compensatory pathways for dopaminergic loss. They improve coordination and motor fluency by strengthening complementary circuits.
Sensory-motor coupling and rhythmic cueing
Music and rhythm provide external cues that partially replace the impaired internal clock in people with Parkinson’s disease, facilitating the initiation and continuity of movement and reducing freezing. The expected effect is improved gait rhythm, reduced hesitations, and immediate gains in walking ability.
Improvement of motor function through cardiovascular and muscular training
Regular exercise increases strength, endurance, and muscle plasticity, which reduces fatigue and may lessen the severity of motor symptoms during ON and OFF periods. The expected outcome is a reduction in motor desynchronization, greater functional reserve, and improved exercise tolerance.
Indirect pharmacokinetic optimization
Education regarding diet, constipation, and dosing timing can improve levodopa absorption (shorter absorption time, fewer fluctuations), contributing to the reduction in OFF time observed in educational studies. The expected outcome is a reduction in OFF episodes.
Adherence and treatment management
Structured learning increases understanding of dosing regimens and interactions (food-drug), which improves adherence and consistency of dosing with a decisive impact on OFF time. Patients and their caregivers seek theoretical and practical knowledge (Krieger 2024; Lang 2025).
Self-efficacy, motivation, and repetition
Programs build self-efficacy, encourage daily practice and the integration of exercises, which prolongs motor and non-motor benefits (Amstrong 2021). The expected outcome is the maintenance of beneficial behaviors over the long term.
Social and emotional effects
Group participation reduces isolation, improves mood and resilience, reduces the burden on caregivers, and increases adherence to recommendations (social reinforcement) all factors correlated with a better quality of life and sustainable functional gains. The patient takes ownership of their condition.
Responding population
Patients with Parkinson’s disease aged 20 to 80 without severe cognitive impairment (MMSE ≥ 24) and with adequate support (De Pandis 2023).
Patients at risk of non-adherence to treatment. Useful for people facing precarious living conditions and social isolation (Gil 2024) as well as caregivers (De Pandis 2023).
Patients at risk of non-adherence to treatment. Useful for people facing precarious living conditions and social isolation (Gil 2024) as well as caregivers (De Pandis 2023).
Nonresponding population
Significant cognitive impairment (severe memory problems/significant impairment of executive functions) that limits understanding, the ability to keep a logbook, and the application of strategies.
Advanced stage of the disease with severely reduced mobility, preventing the performance of practical exercises.
Lack of a dedicated caregiver, preventing daily implementation and travel.
Severe medical comorbidities, particularly cardiovascular and respiratory conditions, increasing risks during sustained physical activity.
Depression, apathy, or low motivation preventing learning.
Logistical (transportation, etc.) or socioeconomic (language, financial resources, access to care, etc.) issues limiting participation and follow-up.
Advanced stage of the disease with severely reduced mobility, preventing the performance of practical exercises.
Lack of a dedicated caregiver, preventing daily implementation and travel.
Severe medical comorbidities, particularly cardiovascular and respiratory conditions, increasing risks during sustained physical activity.
Depression, apathy, or low motivation preventing learning.
Logistical (transportation, etc.) or socioeconomic (language, financial resources, access to care, etc.) issues limiting participation and follow-up.
Participants
Groups
Minimum : 2
Maximum : 20
Minimum : 2
Maximum : 20
Duration
6 weeks
Sessions per week
1 supervized session per week
Procedure
The School of Parkinson program is a therapeutic education program structured around six weekly group sessions held every seven days to address the needs of patients with Parkinson’s disease and their caregivers (De Pandis 2023). Standardization ensures consistency across sessions and covers all major aspects of living with Parkinson’s disease (Mercer 1996) within a care model that has become multidisciplinary (Bloem 2021). The specialized nurse plays a central role as facilitator and coordinator (Thomas 2024). Each session with patients and their caregivers includes one hour of instruction and one hour of practice. Home exercises must be performed, approximately 10 minutes per day for six days. These are collected and reviewed at the next session to verify understanding and adjust implementation as necessary.
The primary goal is to reduce motor fluctuations and OFF periods, and to improve motor and non-motor symptoms, treatment adherence, and independence.
While the nurse coordinates and leads the program, a physician, pharmacist, physical therapist, occupational therapist, physical education teacher, dietitian, or patient advocate may be involved if the situation warrants it. Always keep in mind that a multidisciplinary approach is more beneficial than intervention by a neurologist alone (van der Marck 2013; Eggers 2018; Schrag 2018; Subramanian 2025).
Tailored presentations with video support, followed by group discussions and then individualized practical exercises, are offered. Brochures and a home task log are provided. During the first meeting, the patient and their caregiver receive information and practical advice on the disease, motor and non-motor symptoms, and treatments. They are encouraged to ask as many questions as possible. Part of the meeting is dedicated to learning how to use the ON-OFF log. To verify understanding and ensure adherence, each weekly thematic session was followed by specific daily assignments (10 minutes per day for 6 days so that the patient and caregiver could accurately review the information recorded in the questionnaires completed during the day and at night, as outlined in the practical training). Each “assignment” was collected and reviewed at the next meeting, and additional clarification was provided as needed.
The primary goal is to reduce motor fluctuations and OFF periods, and to improve motor and non-motor symptoms, treatment adherence, and independence.
While the nurse coordinates and leads the program, a physician, pharmacist, physical therapist, occupational therapist, physical education teacher, dietitian, or patient advocate may be involved if the situation warrants it. Always keep in mind that a multidisciplinary approach is more beneficial than intervention by a neurologist alone (van der Marck 2013; Eggers 2018; Schrag 2018; Subramanian 2025).
Tailored presentations with video support, followed by group discussions and then individualized practical exercises, are offered. Brochures and a home task log are provided. During the first meeting, the patient and their caregiver receive information and practical advice on the disease, motor and non-motor symptoms, and treatments. They are encouraged to ask as many questions as possible. Part of the meeting is dedicated to learning how to use the ON-OFF log. To verify understanding and ensure adherence, each weekly thematic session was followed by specific daily assignments (10 minutes per day for 6 days so that the patient and caregiver could accurately review the information recorded in the questionnaires completed during the day and at night, as outlined in the practical training). Each “assignment” was collected and reviewed at the next meeting, and additional clarification was provided as needed.
Components
Each session focuses on a key aspect of Parkinson’s disease and strategies for managing it effectively.
Session 1
Understand motor complications, including recognition of ON/OFF states, dyskinesias, dystonia, and freezing, and learn how to manage the ON/OFF diary and the wearing-off questionnaire.
Session 2
Understanding gastrointestinal issues such as dysphagia, constipation, and food-levodopa interactions, and learning about an appropriate diet.
Session 3
Understanding neuropsychological disorders such as insomnia, drowsiness, mood disorders, and anxiety, and learning strategies for managing and identifying these issues.
Session 4
Understand autonomic dysfunction such as orthostatic hypotension, urinary disorders, sexual problems, and sweating, and learn identification strategies and practical solutions.
Session 5
Understand medication management, including adherence, side effects, and the relationship between meals and levodopa, and learn how to manage dosing.
Session 6
Learn about rehabilitation methods and strategies to promote independence, such as approaches to address freezing, postural instability, and fall prevention, and learn cognitive and instrumental strategies for independence in daily life.
Session 1
Understand motor complications, including recognition of ON/OFF states, dyskinesias, dystonia, and freezing, and learn how to manage the ON/OFF diary and the wearing-off questionnaire.
Session 2
Understanding gastrointestinal issues such as dysphagia, constipation, and food-levodopa interactions, and learning about an appropriate diet.
Session 3
Understanding neuropsychological disorders such as insomnia, drowsiness, mood disorders, and anxiety, and learning strategies for managing and identifying these issues.
Session 4
Understand autonomic dysfunction such as orthostatic hypotension, urinary disorders, sexual problems, and sweating, and learn identification strategies and practical solutions.
Session 5
Understand medication management, including adherence, side effects, and the relationship between meals and levodopa, and learn how to manage dosing.
Session 6
Learn about rehabilitation methods and strategies to promote independence, such as approaches to address freezing, postural instability, and fall prevention, and learn cognitive and instrumental strategies for independence in daily life.
Equipment
- Multipurpose room with seating area and practice zone;
- Modular chairs and tables;
- Non-slip mats;
- Projector + screen or large TV screen;
- Speaker and portable microphone;
- Metronome and music playlist;
- Basic sports equipment (resistance bands, balls, cones);
- Printed materials (slideshow, brochure, flyer, worksheet);
- Hauser notebooks / PD Home Diary (paper or electronic);
- Portable blood pressure monitor, pulse oximeter, first aid kit;
- Computer with internet access;
- Incident log, consent form, safety protocol.
Location
A multipurpose room within a healthcare facility, equipped for both group instruction and practical exercises (seating area + practice zone, projection and rehabilitation equipment).
Best implementation practices
- Encourage interaction and guided practice.
- Training in the personalized adaptation of messages is key to the success of the NPI. This training should also focus on a holistic approach to care, support for self-management, and health coaching, and, if possible, telemedicine (Van Munster 2021).
- Draw on classic works on therapeutic education for patients with chronic conditions, such as those from the HAS (2014) and the WHO (2023).
- Draw inspiration from educational messages provided by recognized organizations such as the World Parkinson’s Program (2025), Parkinson Europe (2025), or Parkinson Canada (2025).
- Offer this NPI even to patients with advanced-stage Parkinson’s disease (Rosqvist 2021).
- Training in the personalized adaptation of messages is key to the success of the NPI. This training should also focus on a holistic approach to care, support for self-management, and health coaching, and, if possible, telemedicine (Van Munster 2021).
- Draw on classic works on therapeutic education for patients with chronic conditions, such as those from the HAS (2014) and the WHO (2023).
- Draw inspiration from educational messages provided by recognized organizations such as the World Parkinson’s Program (2025), Parkinson Europe (2025), or Parkinson Canada (2025).
- Offer this NPI even to patients with advanced-stage Parkinson’s disease (Rosqvist 2021).
Best practices for sustainability
- Take sufficient time to train program staff in order to strengthen buy-in and maximize benefits (Derollez 2021).
- Recognize that coordination among healthcare professionals is crucial (Cressatti 2024).
- Recognize that coordination among healthcare professionals is crucial (Cressatti 2024).
Precautions
Before the session
The practitioner verifies the identities of the patient and the caregiver.
The practitioner obtains informed consent.
The practitioner requests permission to document any incidents.
An emergency contact form (phone number, primary care physician) must be completed.
Monitoring of comorbidities (recent cardiopulmonary evaluation if relevant history, identified contraindications).
The list of treatments will be reviewed by requesting the prescription sheet and any recent changes.
Time will be set aside with the caregiver for further explanation if necessary.
Instructions will be given to the patient and the caregiver before the start of each session.
Sessions will be scheduled during the ON period if possible.
The objective of each session, its duration, and the homework (10 min/day) will be explained.
Warning signs and the immediate stop procedure will be reviewed.
The current status (ON/OFF) will be assessed and noted in the logbook.
Blood pressure and oxygen saturation may be measured if the patient’s history warrants it. **
During the session
The presence of a trained healthcare professional is required during the exercise.
The professional will monitor the patient continuously and watch for signs of fatigue, shortness of breath, pain, dizziness, and low blood pressure.
The exercise must be stopped immediately in the event of dizziness, chest pain, fainting, or a fall.
Record any proposed medication changes and confirm them with the neurologist as needed. In the event of an incident, the primary care physician and the referring neurologist will be notified.
After the session
A review of the exercises and a check to ensure they are understood will be conducted (10 min/day).
Time will be set aside to discuss the session with patients and caregivers to gather feedback, and participation will be noted.
A record of any adverse events will be maintained.
The practitioner verifies the identities of the patient and the caregiver.
The practitioner obtains informed consent.
The practitioner requests permission to document any incidents.
An emergency contact form (phone number, primary care physician) must be completed.
Monitoring of comorbidities (recent cardiopulmonary evaluation if relevant history, identified contraindications).
The list of treatments will be reviewed by requesting the prescription sheet and any recent changes.
Time will be set aside with the caregiver for further explanation if necessary.
Instructions will be given to the patient and the caregiver before the start of each session.
Sessions will be scheduled during the ON period if possible.
The objective of each session, its duration, and the homework (10 min/day) will be explained.
Warning signs and the immediate stop procedure will be reviewed.
The current status (ON/OFF) will be assessed and noted in the logbook.
Blood pressure and oxygen saturation may be measured if the patient’s history warrants it. **
During the session
The presence of a trained healthcare professional is required during the exercise.
The professional will monitor the patient continuously and watch for signs of fatigue, shortness of breath, pain, dizziness, and low blood pressure.
The exercise must be stopped immediately in the event of dizziness, chest pain, fainting, or a fall.
Record any proposed medication changes and confirm them with the neurologist as needed. In the event of an incident, the primary care physician and the referring neurologist will be notified.
After the session
A review of the exercises and a check to ensure they are understood will be conducted (10 min/day).
Time will be set aside to discuss the session with patients and caregivers to gather feedback, and participation will be noted.
A record of any adverse events will be maintained.
Regulatory specification
Medical prescription (Boege 2024).
The patient’s right to information as outlined in a specific European charter, the EPDA Charter for People with Parkinson’s Disease (Bloem 2012). In France, the practitioner must have completed a 40-hour training course in Therapeutic education recognized by a Regional Health Agency (HAS 2014).
The patient’s right to information as outlined in a specific European charter, the EPDA Charter for People with Parkinson’s Disease (Bloem 2012). In France, the practitioner must have completed a 40-hour training course in Therapeutic education recognized by a Regional Health Agency (HAS 2014).
Main Initiator
Maria Francesca De Pandis, Rossella Rotondo, Maria Levi Della Vida et Valeria Servodidio, San Raffaele Cassino, Cassino, Italie.
Margherita Torti, Miriam Casali, Laura Vacca, Stefania Proietti, Fabrizio Stocchi, IRCCS San Raffaele Roma, Rome, Italie.
Lanfranco Lodice, Italian Health Ministry c/o USMAF Campania, Naples, Italie Fabio Viselli, San Giovanni Battista Hospital, Rome, Italie.
Margherita Torti, Miriam Casali, Laura Vacca, Stefania Proietti, Fabrizio Stocchi, IRCCS San Raffaele Roma, Rome, Italie.
Lanfranco Lodice, Italian Health Ministry c/o USMAF Campania, Naples, Italie Fabio Viselli, San Giovanni Battista Hospital, Rome, Italie.
Qualification required
Professional trained at the NPI.
In France, practitioners must have completed a 40-hour full-time training program recognized by a Regional Health Agency.
In France, practitioners must have completed a 40-hour full-time training program recognized by a Regional Health Agency.
References
Prototype study
Mercer BS. A randomized study of the efficacy of the PROPATH Program for patients with Parkinson disease. Arch Neurol. 1996 Sep;53(9):881-4. https://dx.doi.org/10.1001/archneur.1996.00550090087014
Mechanistic study
Armstrong M et al. Health care professionals' perspectives on self-management for people with Parkinson's: qualitative findings from a UK study. BMC Geriatr. 2021 Dec 15;21(1):706. https://dx.doi.org/10.1186/s12877-021-02678-w
Interventional studies
De Pandis MF et al. Therapeutic education for empowerment and engagement in patients with Parkinson's disease: A non-pharmacological, interventional, multicentric, randomized controlled trial. Front Neurol. 2023 Apr 18;14:1167685. https://dx.doi.org/10.3389/fneur.2023.1167685
Connor KI et al. Randomized trial of care management to improve Parkinson disease care quality. Neurology. 2019 Apr 16;92(16):e1831-e1842. https://dx.doi.org/10.1212/WNL.0000000000007324
Implementation study in Europe
Derollez C et al. Factors that predict a change in quality of life among Parkinson's disease patients participating in a patient education program. Rev Neurol (Paris). 2021 Nov;177(9):1151-1159. https://dx.doi.org/10.1016/j.neurol.2021.01.020
Other publications
Bloem BR et al. Move for change part I: a European survey evaluating the impact of the EPDA Charter for People with Parkinson's disease. Eur J Neurol. 2012 Mar;19(3):402-10. https://dx.doi.org/10.1111/j.1468-1331.2011.03532.x
Bloem BR et al. Parkinson's disease. Lancet. 2021 Jun 12;397(10291):2284-2303. https://dx.doi.org/10.1016/S0140-6736(21)00218-X
Boege S et al. Self-Management Systems for Patients and Clinicians in Parkinson's Disease Care: A Scoping Review. J Parkinsons Dis. 2024;14(7):1387-1404. https://dx.doi.org/10.3233/JPD-240137
Cressatti M et al. Advancing Parkinson's Disease Research in Canada: The Canadian Open Parkinson Network (C-OPN) Cohort. J Parkinsons Dis. 2024;14(7):1481-1494. https://dx.doi.org/10.3233/JPD-240213
Eggers C et al. Patient-centered integrated healthcare improves quality of life in Parkinson's disease patients: a randomized controlled trial. J Neurol. 2018 Apr;265(4):764-773. https://dx.doi.org/10.1007/s00415-018-8761-7
Gil G et al. The impact of the socioeconomic factor on Parkinson's disease medication adherence: a scoping review. Arq Neuropsiquiatr. 2024 Feb;82(2):1-8. https://dx.doi.org/10.1055/s-0044-1779608
Grosset KA et al. Effect of educational intervention on medication timing in Parkinson's disease: a randomized controlled trial. BMC Neurol. 2007 Jul 16;7:20. https://dx.doi.org/10.1186/1471-2377-7-20
HAS.Éducation thérapeutique du patient (ETP). Haute Autorité de Santé, Saint Denis La Plaine, 2014. https://www.has-sante.fr/jcms/c_1241714/fr/education-therapeutique-du-patient-etp
Hauser RA et al. Parkinson's disease home diary: further validation and implications for clinical trials. Mov Disord. 2004 Dec;19(12):1409-13. https://dx.doi.org/10.1002/mds.20248
Kang E et al. Empowerment in people with Parkinson's disease: A scoping review and qualitative interview study. Patient Educ Couns. 2022 Oct;105(10):3123-3133. https://dx.doi.org/10.1016/j.pec.2022.06.003
Krieger T et al. Exploring the lived experiences of individuals with Parkinson's disease and their relatives: insights into care provision experiences, disease management support, self-management strategies, and future needs in Germany (qualitative study). BMC Neurol. 2024 Jun 18;24(1):208. https://dx.doi.org/10.1186/s12883-024-03696-y
Lang T et al. The diagnostic pathway of Parkinson's disease: understanding patient perspectives in Australia. NPJ Parkinsons Dis. 2025 Apr 30;11(1):104. https://dx.doi.org/10.1038/s41531-025-00968-3
Löhle M et al. Validation of the PD home diary for assessment of motor fluctuations in advanced Parkinson's disease. NPJ Parkinsons Dis. 2022 Jun 2;8(1):69. https://dx.doi.org/10.1038/s41531-022-00331-w
Mathur S et al. Patient Empowerment for Those Living with Parkinson's Disease. J Parkinsons Dis. 2024;14(s1):S173-S180. https://dx.doi.org/10.3233/JPD-230235
Parkinson Canada. https://www.parkinson.ca/
Parkinson Europe. https://parkinsonseurope.org/
Pigott JS et al. Systematic review and meta-analysis of clinical effectiveness of self-management interventions in Parkinson's disease. BMC Geriatr. 2022 Jan 11;22(1):45. https://dx.doi.org/10.1186/s12877-021-02656-2
Rosqvist K et al. Kylberg M, Löfqvist C, Schrag A, Odin P, Iwarsson S. Perspectives on Care for Late-Stage Parkinson's Disease. Parkinsons Dis. 2021 Mar 15;2021:9475026. https://dx.doi.org/10.1155/2021/9475026
Schrag A et al. Experience of care for Parkinson's disease in European countries: a survey by the European Parkinson's Disease Association. Eur J Neurol. 2018 Dec;25(12):1410-e120. https://dx.doi.org/10.1111/ene.13738
Subramanian I et al. A Holistic Wellness Prescription for Parkinson's Disease: Evidence-Based Perspectives and Unmet Needs. Mov Disord Clin Pract. 2025 Oct 14. https://dx.doi.org/10.1002/mdc3.70381
Thomas S et al. Parkinson's Nurses Are Crucial for the Management of Parkinson's Disease: 2007-2024. J Parkinsons Dis. 2024;14(s1):S209-S217. https://dx.doi.org/10.3233/JPD-230224
van der Marck MA et al. Effectiveness of multidisciplinary care for Parkinson's disease: a randomized, controlled trial. Mov Disord. 2013 May;28(5):605-11. https://dx.doi.org/10.1002/mds.25194
Van Munster M et al. Moving towards Integrated and Personalized Care in Parkinson's Disease: A Framework Proposal for Training Parkinson Nurses. J Pers Med. 2021 Jun 30;11(7):623. https://dx.doi.org/10.3390/jpm11070623
Wang G et al. Current approaches for the management of Parkinson's disease in Chinese hospitals: a cross-sectional survey. BMC Neurol. 2018 Aug 22;18(1):122. https://dx.doi.org/10.1186/s12883-018-1122-4
WHO.Therapeutic patient education An introductory guide. World Health Organization Regional Office for Europe, Copenhagen, 2023. https://www.who.int/europe/teams/ncd-management/therapeutic-patient-education
World Parkinson’s Program. https://pdprogram.org/brochure/
Mercer BS. A randomized study of the efficacy of the PROPATH Program for patients with Parkinson disease. Arch Neurol. 1996 Sep;53(9):881-4. https://dx.doi.org/10.1001/archneur.1996.00550090087014
Mechanistic study
Armstrong M et al. Health care professionals' perspectives on self-management for people with Parkinson's: qualitative findings from a UK study. BMC Geriatr. 2021 Dec 15;21(1):706. https://dx.doi.org/10.1186/s12877-021-02678-w
Interventional studies
De Pandis MF et al. Therapeutic education for empowerment and engagement in patients with Parkinson's disease: A non-pharmacological, interventional, multicentric, randomized controlled trial. Front Neurol. 2023 Apr 18;14:1167685. https://dx.doi.org/10.3389/fneur.2023.1167685
Connor KI et al. Randomized trial of care management to improve Parkinson disease care quality. Neurology. 2019 Apr 16;92(16):e1831-e1842. https://dx.doi.org/10.1212/WNL.0000000000007324
Implementation study in Europe
Derollez C et al. Factors that predict a change in quality of life among Parkinson's disease patients participating in a patient education program. Rev Neurol (Paris). 2021 Nov;177(9):1151-1159. https://dx.doi.org/10.1016/j.neurol.2021.01.020
Other publications
Bloem BR et al. Move for change part I: a European survey evaluating the impact of the EPDA Charter for People with Parkinson's disease. Eur J Neurol. 2012 Mar;19(3):402-10. https://dx.doi.org/10.1111/j.1468-1331.2011.03532.x
Bloem BR et al. Parkinson's disease. Lancet. 2021 Jun 12;397(10291):2284-2303. https://dx.doi.org/10.1016/S0140-6736(21)00218-X
Boege S et al. Self-Management Systems for Patients and Clinicians in Parkinson's Disease Care: A Scoping Review. J Parkinsons Dis. 2024;14(7):1387-1404. https://dx.doi.org/10.3233/JPD-240137
Cressatti M et al. Advancing Parkinson's Disease Research in Canada: The Canadian Open Parkinson Network (C-OPN) Cohort. J Parkinsons Dis. 2024;14(7):1481-1494. https://dx.doi.org/10.3233/JPD-240213
Eggers C et al. Patient-centered integrated healthcare improves quality of life in Parkinson's disease patients: a randomized controlled trial. J Neurol. 2018 Apr;265(4):764-773. https://dx.doi.org/10.1007/s00415-018-8761-7
Gil G et al. The impact of the socioeconomic factor on Parkinson's disease medication adherence: a scoping review. Arq Neuropsiquiatr. 2024 Feb;82(2):1-8. https://dx.doi.org/10.1055/s-0044-1779608
Grosset KA et al. Effect of educational intervention on medication timing in Parkinson's disease: a randomized controlled trial. BMC Neurol. 2007 Jul 16;7:20. https://dx.doi.org/10.1186/1471-2377-7-20
HAS.Éducation thérapeutique du patient (ETP). Haute Autorité de Santé, Saint Denis La Plaine, 2014. https://www.has-sante.fr/jcms/c_1241714/fr/education-therapeutique-du-patient-etp
Hauser RA et al. Parkinson's disease home diary: further validation and implications for clinical trials. Mov Disord. 2004 Dec;19(12):1409-13. https://dx.doi.org/10.1002/mds.20248
Kang E et al. Empowerment in people with Parkinson's disease: A scoping review and qualitative interview study. Patient Educ Couns. 2022 Oct;105(10):3123-3133. https://dx.doi.org/10.1016/j.pec.2022.06.003
Krieger T et al. Exploring the lived experiences of individuals with Parkinson's disease and their relatives: insights into care provision experiences, disease management support, self-management strategies, and future needs in Germany (qualitative study). BMC Neurol. 2024 Jun 18;24(1):208. https://dx.doi.org/10.1186/s12883-024-03696-y
Lang T et al. The diagnostic pathway of Parkinson's disease: understanding patient perspectives in Australia. NPJ Parkinsons Dis. 2025 Apr 30;11(1):104. https://dx.doi.org/10.1038/s41531-025-00968-3
Löhle M et al. Validation of the PD home diary for assessment of motor fluctuations in advanced Parkinson's disease. NPJ Parkinsons Dis. 2022 Jun 2;8(1):69. https://dx.doi.org/10.1038/s41531-022-00331-w
Mathur S et al. Patient Empowerment for Those Living with Parkinson's Disease. J Parkinsons Dis. 2024;14(s1):S173-S180. https://dx.doi.org/10.3233/JPD-230235
Parkinson Canada. https://www.parkinson.ca/
Parkinson Europe. https://parkinsonseurope.org/
Pigott JS et al. Systematic review and meta-analysis of clinical effectiveness of self-management interventions in Parkinson's disease. BMC Geriatr. 2022 Jan 11;22(1):45. https://dx.doi.org/10.1186/s12877-021-02656-2
Rosqvist K et al. Kylberg M, Löfqvist C, Schrag A, Odin P, Iwarsson S. Perspectives on Care for Late-Stage Parkinson's Disease. Parkinsons Dis. 2021 Mar 15;2021:9475026. https://dx.doi.org/10.1155/2021/9475026
Schrag A et al. Experience of care for Parkinson's disease in European countries: a survey by the European Parkinson's Disease Association. Eur J Neurol. 2018 Dec;25(12):1410-e120. https://dx.doi.org/10.1111/ene.13738
Subramanian I et al. A Holistic Wellness Prescription for Parkinson's Disease: Evidence-Based Perspectives and Unmet Needs. Mov Disord Clin Pract. 2025 Oct 14. https://dx.doi.org/10.1002/mdc3.70381
Thomas S et al. Parkinson's Nurses Are Crucial for the Management of Parkinson's Disease: 2007-2024. J Parkinsons Dis. 2024;14(s1):S209-S217. https://dx.doi.org/10.3233/JPD-230224
van der Marck MA et al. Effectiveness of multidisciplinary care for Parkinson's disease: a randomized, controlled trial. Mov Disord. 2013 May;28(5):605-11. https://dx.doi.org/10.1002/mds.25194
Van Munster M et al. Moving towards Integrated and Personalized Care in Parkinson's Disease: A Framework Proposal for Training Parkinson Nurses. J Pers Med. 2021 Jun 30;11(7):623. https://dx.doi.org/10.3390/jpm11070623
Wang G et al. Current approaches for the management of Parkinson's disease in Chinese hospitals: a cross-sectional survey. BMC Neurol. 2018 Aug 22;18(1):122. https://dx.doi.org/10.1186/s12883-018-1122-4
WHO.Therapeutic patient education An introductory guide. World Health Organization Regional Office for Europe, Copenhagen, 2023. https://www.who.int/europe/teams/ncd-management/therapeutic-patient-education
World Parkinson’s Program. https://pdprogram.org/brochure/
Experts who voted for the publication of this sheet
FRANCO Gianni , NINOT Grégory , NOGUES MichelAuthor(s) of the Sheet
NPIS (comité scientifique)
Creation Date : 12/03/2026
Revision Date : 14/04/2026
Version : V01
Revision Date : 14/04/2026
Version : V01
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