Device-Assisted Therapies for Parkinson Disease

In this informative podcast episode from Australian Prescriber, GP host Dr Laura Beaton sits down with senior pharmacist Nadia Mouchaileh and neurologist Dr Jill Cameron to unpack the world of device-assisted therapies for Parkinson’s disease — specifically for those patients who are no longer responding well to standard oral or transdermal meds.
CPD HOURS: 0.5
 Registration Year 2024-2025

Course Content

In this informative podcast episode from Australian Prescriber, GP host Dr Laura Beaton sits down with senior pharmacist Nadia Mouchaileh and neurologist Dr Jill Cameron to unpack the world of device-assisted therapies for Parkinson’s disease—specifically for those patients who are no longer responding well to standard oral or transdermal meds.

The conversation explores when and why you’d escalate treatment beyond pills and patches. As Parkinson’s progresses, patients often face unpredictable symptom control, fluctuating between “on” (good motor control) and “off” (symptoms return) periods. Cue the need for more advanced interventions.

They cover a range of options, including:
Apomorphine infusions
– A portable subcutaneous pump that delivers steady dopamine stimulation during the day, helping smooth out those infuriating motor swings. Handy, discreet, and a step up from rescue pen injections.

Levodopa intestinal gel (Duodopa)
– For when gut absorption becomes a major hurdle. Administered directly into the small intestine via a surgically inserted PEJ tube. Yes, more invasive—but a game-changer for the right patient.

Emerging therapies
– Watch this space for Lecigon (levodopa/carbidopa/entacapone) and a new subcutaneous levodopa option currently making its way through the PBS.Deep brain stimulation (DBS) – The heavyweight contender of Parkinson’s treatment.

Electrodes implanted in the brain offer remarkable symptom control for some—but not without surgical and neurological risks. The team emphasises the importance of early referral to movement disorder clinics, especially when quality of life is taking a hit and the “5-2-1 rule” applies (5 daily levodopa doses, 2+ hours of off time, 1+ hour of troublesome dyskinesia).GPs have a vital role in monitoring side effects, troubleshooting device issues, and liaising with specialists.

From injection site irritation to post-op infection risks, primary care plays a critical support role once patients are back in the community. They also touch on models of care for rural and regional patients—telehealth, community nurse support, and outreach clinics are slowly helping bridge the metro–bush divide.

Take-home message: Device-assisted therapies aren’t last resorts—they’re precision tools to tailor care for people living with advanced Parkinson’s. Knowing when to refer and what to watch for can make a world of difference.

Why this session may be relevant to your work

As a registered nurse I need to keep up to date with the lasted information on pharmacology and treatment options in order to ensure the best outcome for my clients 

Learning Outcomes

In this session, you will:
  • Identify the clinical indicators that suggest a patient with Parkinson’s disease may benefit from device-assisted therapy
  • Describe the mechanisms, benefits, and limitations of apomorphine infusions, levodopa–carbidopa intestinal gel, and deep brain stimulation
  • Apply the ‘5-2-1 Rule’ to assess readiness for specialist referral to movement disorder services
  • Outline the primary care team’s role in supporting patients undergoing device-assisted therapies, including monitoring for complications and promoting adherence

Australian Prescriber

The Australian Prescriber Podcast provides a regular dive into some of the many great articles that Australian Prescriber publishes every two months.

In each episode, one of our hosts will chat with an author from a recent issue of Australian Prescriber.