2024-04-12 17:30:16
The disease progressed slowly
38-year-old Erika Persijanova felt the first symptoms of Parkinson’s disease when she was just 15 years old, but at that time she did not take them too seriously and did not even think that it was something more than a temporary ailment.
“When walking longer distances, the foot of one leg started to drag. I walk and feel that I am not placing my foot on the sole, but on the side of the foot. This started happening more and more until I felt I could walk shorter and shorter distances. At that time, doctors recommended taking magnesium. Then I didn’t think too much about it, because at first it didn’t interfere with life, I just started avoiding long distances”, recalls E. Persijanova.
After some time, the interviewee began to feel that she could no longer walk a greater distance, but her walking speed slowed down a lot. “It became more and more difficult to keep the balance. Leg cramps were also more frequent. Fingers became unruly, and small household chores became more and more difficult. At the time, I didn’t really understand what was going on, because to walk faster or stand straight, you had to put in a lot of effort.”
When Erika’s health worsened, she went to the doctor and started looking for the cause of her ailments. “Time passed, the tests did not show anything wrong, and I was getting more and more scared. It was harder to go every day. More than a year passed before the disease was diagnosed and drugs were applied. And today I am especially grateful to the doctors and neurologists of the Kaunas Clinics of the Lithuanian University of Health Sciences Hospital, thanks to whom I found out about my diagnosis. In 2022, I was diagnosed with a PKRN gene mutation and diagnosed with juvenile-onset parkinsonism using the next-generation gene sequencing method.
A brain neurostimulator for a better quality of life
Already for the ninth year in Lithuania, patients suffering from a severe form of the disease have been compensated by the Compulsory Health Insurance Fund (PSDF) for one of the treatment methods for this disease – a neurostimulator implanted in the brain. This operation is performed in the Kaunas Clinics of the Lithuanian University of Health Sciences Hospital and in the Santaras Clinics of the Vilnius University Hospital.
“After the doctors diagnosed dystonia, I started looking for information on the Internet. That’s how I met a girl who had already had a neurostimulator implanted. After some time, I developed dyskinesia from taking a large amount of medication, so I was also offered deep brain stimulation surgery. After the operation, I felt the improvement immediately. Today, it’s been almost four years since I’ve been living with a brain neurostimulator, which was implanted in Lithuania and fully paid for by the Mandatory Health Insurance Fund,” says the interviewer.
The disease has not disappeared anywhere and reminds of itself every day. “I still have balance problems, muscle stiffness and difficulty walking, but I’m on less muscle relaxants and can do a lot more since the surgery. If the disease progresses, there is an opportunity to change the settings of the stimulator, which improves the state of health and quality of life every time,” E. Persijanova concludes the interview frankly.
State sick fund under the Ministry of Health (VLK) in 2023. at the beginning allocated 1.44 million to treatment facilities for two years. euros to purchase neurostimulators. It is estimated that about 100 neurostimulators can be purchased for the allocated amount. Last year in Lithuania neurostimulators paid for by PSDF funds were implanted in 29 patients.
Compensates for necessary medications
Currently, health insurance funds reimburse 9 names of drugs for the treatment of Parkinson’s disease and secondary parkinsonism with funds from the PSDF budget. Among them are levodopa preparations, centrally acting myorelaxants, dopamine agonists, anticholinergic preparations, NMDA receptor antagonists, KOMT inhibitors, MAO B inhibitors.
In Lithuania, all drugs prescribed for the treatment of Parkinson’s disease are reimbursed 100%. base prices.
According to VLK, last year in Lithuania more than 9 thousand patients with Parkinson’s disease or secondary parkinsonism used compensatory drugs. In total, 58 thousand were issued last year. compensatory drug prescriptions. It took almost 1.8 million to pay them. EUR from PSDF.
To relieve symptoms – medical rehabilitation
For those suffering from Parkinson’s disease, a physical medicine and rehabilitation doctor, after assessing the patient’s condition, can prescribe initial, outpatient or inpatient rehabilitation services paid for by the PSDF.
Inpatient rehabilitation services are usually provided after inpatient treatment, and outpatient rehabilitation services are provided both after inpatient treatment and after initial outpatient rehabilitation services if functional impairments persist.
For patients with 0-40% level of participation, payment by the health insurance fund and supportive rehabilitation, which can be provided once a year.
Rehabilitation is prescribed by a doctor of physical medicine and rehabilitation, and a referral for these services is issued by a doctor of physical medicine and rehabilitation or an inpatient treating physician.
It is estimated that last year about 317 people with Parkinson’s disease used initial outpatient rehabilitation services, 94 – outpatient rehabilitation, 262 – inpatient rehabilitation services. Of these, 88 patients received supportive rehabilitation services. To pay for all these medical rehabilitation services last year, PSDF required 392 thousand. euros.
Expensive research helps monitor changes
Although the diagnosis of Parkinson’s disease is based on the main clinical symptoms, the majority of sufferers undergo brain imaging tests, which are classified as expensive tests – computed tomography, magnetic resonance tomography, sometimes radionuclide computed tomography, positron emission tomography. There are no specific neuroimaging tests that confirm Parkinson’s disease, but after they are performed, certain changes characteristic of Parkinson’s disease can be observed and other causes of the disease can be ruled out.
It is important to know that expensive tests can be prescribed only by specialist doctors who can evaluate the results of the performed test and prescribe the necessary treatment. Registration for the study is required within 180 days.
You can find a list of health care institutions that have concluded contracts with territorial health insurance funds for the provision of expensive tests throughout Lithuania here.
2024-04-12 17:30:16