Impact Stories

Parkinson’s disease is the second most common neurological condition worldwide, yet it remains one of the least understood.
Around 200,000 Australians are currently living with Parkinson’s disease. The condition occurs when dopamine-producing brain cells are damaged or lost, leading to symptoms such as tremors, stiffness, slowed movement and balance problems. While the risk of developing Parkinson’s increases with age, genetic and environmental factors also contribute. Early diagnosis and timely access to appropriate medication are critical to maintaining quality of life.

Geography shapes Parkinson’s care
For Dr Peter Micalos, senior lecturer in anatomy and physiology at Charles Sturt University, a central question was whether location determines access to appropriate Parkinson’s treatment.

“Understanding how care differs depending on where people live is crucial. Without that insight, it’s very difficult to ensure patients are receiving equitable and effective treatment,” Dr Micalos said.

Using linked health data, Dr Micalos and colleagues uncovered significant differences in Parkinson’s medication prescribing across New South Wales.

Their study found differences in the proportion of levodopa and levodopa combination prescriptions, the gold standard medications for managing Parkinson’s disease. Specifically, prescribing rates for these medications were lower in regional and remote areas compared with major cities, highlighting a geographic disparity.

Moreover, people living in metropolitan areas are more likely to have access to neurologists who can provide timely diagnosis, monitor disease progression and optimise medication regimens. In contrast, those living hundreds of kilometres from specialist services may rely primarily on general practitioners to manage a progressive neurological condition, potentially resulting in delayed treatment adjustments and less effective symptom control.

Why specialist access matters

“Parkinson’s disease is a complex, progressive condition, and managing it effectively requires access to specialist knowledge and ongoing review of treatment. When that access is limited, it can directly affect patient outcomes,” Dr Micalos said.

The findings highlight a challenge faced by many Australians with chronic and complex conditions: access to specialist care. And the consequences can be substantial. Reduced mobility, difficulties performing everyday activities, impacts on employment, and decreased social participation can affect not only individuals living with Parkinson’s, but also their families, carers and communities.

Pharmaceutical therapy remains the cornerstone of Parkinson’s disease management, helping people maintain independence and quality of life. It is often complemented by non-pharmaceutical interventions such as physiotherapy and speech therapy.

These treatment disparities had remained largely invisible until researchers were able to link data sources through Data Connect Australia-funded infrastructure.

Using the Secure Unified Research[RG1.1][RG1.2][RG1.3] Environment (SURE), supported by Data Connect Australia., the research team securely linked data from the Sax Institute’s 45 and Up Study with Pharmaceutical Benefits Scheme records spanning 2004–2017. This enabled researchers to identify who was receiving Parkinson’s medications, what treatments were being prescribed, and how access varied across geographic regions—insights that would not have been possible from any single dataset.

“Linked data allows us to look beyond individual cases and understand patterns of care across entire populations. That’s essential for identifying inequities and informing better health policy,” he said.