To relieve the problems of the progressively aging population in Japan, the Ministry of Health, Labor and Welfare decided to focus on the treatment of high-incidence diseases and the establishment of effective medical technologies. As a result of these shifts in policy, the Societas Neurologica Japonica formed several ad hoc committees to collect materials in order to establish evidence-based guidelines for the treatment of highly prevalent diseases including Parkinson's disease (PD). Evidence levels and recommendations were based on the standards employed by the US Agency for Health Care Research and Quality (AHCPR). The Societas Neurologica Japonica PD treatment guidelines were established to support appropriate treatment and to offer efficient medical services in daily medical practice. The guidelines should be used as a reference, not to restrict treatment, which should be based on patients' values and physicians' expertise.
The guidelines for PD are based on materials that were available at the end of 2001, so there are some points that should be modified according to new evidence. For treatment methods, high-evidence-level materials were not available for all items, so guidelines for items with little evidence were prepared on the basis of the opinions of specialist physicians.
Some may be critical of this approach, but the introduction of treatment methods appeared welcome to front-line medical providers. In an assessment carried out in 2005, the PD treatment guidelines were found to be useful and easy to understand and use and it was proposed to revise them every few years. This article provides an outline of the guidelines.
Treatment guidelines Societas Neurologica Japonica Initial treatment Progressive stage PD Motor complications