scholarly journals Evaluation of motor complications in Parkinson’s disease: understanding the perception gap between patients and physicians

2021 ◽  
Author(s):  
Hiromu Ogura ◽  
Ryoko Nakagawa ◽  
Miwako Ishido ◽  
Yoko Yoshinaga ◽  
Jun Watanabe ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Practice ◽  
Routine Clinical Practice ◽  
Self Awareness ◽  
Motor Complications ◽  
Physician Assessment ◽  
Wearing Off ◽  
Perception Gap

Abstract Background: Patients with Parkinson’s disease (PD) receiving levodopa treatment often report the motor complications including wearing-off (WO), dyskinesia and morning akinesia phenomena. Since motor complications are associated with a decrease in patient quality of life (QoL), it is important to identify its occurrence and commence immediate management. This study investigated whether differences in the perception of motor complications exist between patients and their physicians in routine clinical practice.Methods: Following an internet-based screening survey, questionnaires were distributed to physicians and their patients in Japan. The 9-item Wearing-off Questionnaire (WOQ-9) assessed the presence of WO objectively; patients with WOQ-9 scores ≥2 were considered to have WO. McNemar’s tests were used to compare physician assessment with the WOQ-9, patient self-awareness with physician assessment, and patient self-awareness with the WOQ-9, separately. Morning akinesia, dyskinesia, and QoL were also assessed.Results: A total of 235 patients with PD and their 92 physicians participated in this survey. A significant discordance was observed between the WOQ-9 and physician assessment of WO (67.2% vs 46.0%; p<0.0001). Furthermore, patient self-awareness of WO was 35.3% (p=0.0004, vs physician). Morning akinesia (patient, 58.7%; physician, 48.9%; p=0.0032), dyskinesia (patient, 34.0%; physician, 23.4%; p=0.0006), and bodily discomfort (patient, 25.0; physician, 0.0; p=0.0102) of QoL were underrecognized by physicians. Conclusions: This study investigated differences in the perception of WO between patients with PD and their physicians in routine clinical practice and highlighted that patients have a low awareness of the symptoms of WO compared with physician assessments and the WOQ-9. Conversely, morning akinesia, dyskinesia, and bodily discomfort were underrecognized by physicians.

scholarly journals Evaluation of Motor Complications in Parkinson’s Disease: Understanding the Perception Gap between Patients and Physicians

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hiromu Ogura ◽  
Ryoko Nakagawa ◽  
Miwako Ishido ◽  
Yoko Yoshinaga ◽  
Jun Watanabe ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Practice ◽  
Routine Clinical Practice ◽  
Self Awareness ◽  
Motor Complications ◽  
Physician Assessment ◽  
Wearing Off ◽  
Mcnemar’S Test ◽  
Mcnemar's Test

Background. Patients with Parkinson’s disease (PD) receiving levodopa treatment often report motor complications including wearing-off (WO), dyskinesia, and morning akinesia. As motor complications are associated with a decrease in patients’ quality of life (QoL), it is important to identify their occurrence and commence immediate management. This study investigated whether differences in the perception of motor complications exist between patients and their physicians in routine clinical practice. Methods. After an Internet-based screening survey, questionnaires were distributed to physicians and their patients in Japan. The 9-item Wearing-Off Questionnaire (WOQ-9) was used to objectively assess the presence of WO; patients with WOQ-9 scores ≥2 were considered to have WO. McNemar’s test was used to compare physician assessment versus WOQ-9 scores, patient self-awareness versus physician assessment, and patient self-awareness versus WOQ-9, separately. Morning akinesia and dyskinesia were assessed by both physician assessment and patient self-awareness with McNemar’s test. QoL was assessed using the 8-item Parkinson’s Disease Questionnaire (PDQ-8) with the Wilcoxon rank-sum test. Results. A total of 235 patients with PD and their 92 physicians participated in this survey. A significant discordance was observed between the WOQ-9 and physician assessment of WO (67.2% vs 46.0%; p < 0.0001 ). Furthermore, patient self-awareness of WO was 35.3% ( p = 0.0004 , vs physician). Morning akinesia (patient, 58.7%; physician, 48.9%; p = 0.0032 ), dyskinesia (patient, 34.0%; physician, 23.4%; p = 0.0006 ), and bodily discomfort (patient, 25.0; physician, 0.0; p = 0.0102 ) of QoL were underrecognized by physicians. Conclusions. This study investigated differences in the perception of WO between patients with PD and their physicians in routine clinical practice and highlighted that patients have a low awareness of the symptoms of WO compared with physician assessments and WOQ-9. Conversely, morning akinesia, dyskinesia, and bodily discomfort were underrecognized by physicians.

scholarly journals Az orális levodopakezelés jellegzetességei előrehaladott Parkinson-kórban a marosvásárhelyi neurológiai klinikák tapasztalatában

2019 ◽  
Vol 160 (17) ◽  
pp. 662-669 ◽  
Author(s):  
József Attila Szász ◽  
Szabolcs Szatmári ◽  
Viorelia Constantin ◽  
István Mihály ◽  
Attila Rácz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Multidisciplinary Teams ◽  
Motor Complications ◽  
Levodopa Dose ◽  
Advanced Parkinson’S Disease ◽  
Upper Limits ◽  
Severe Motor ◽  
Administration Rate

Abstract: Introduction: The motor and non-motor complications of Parkinson’s disease impair the patients’ quality of life and limit therapeutical options. There are no clear criteria for ‘advanced’ Parkinson’s disease or for the optimal moment for invasive therapies. There is little evidence regarding the upper limits of levodopa doses, and how these may be influenced by the availability of device-aided therapies. Aim: To analyze substitution therapy in patients with advanced Parkinson’s disease. Method: In our retrospective study, we analyzed the data from all patients with advanced Parkinson’s disease hospitalized between 1st June 2011 and 31st May 2017, receiving combined levodopa treatment at least 4×/day, reporting a minimum of 2 hours off periods, with or without dyskinesia. We analyzed levodopa therapy for patients who were recommended either device-aided or conservative therapy. Results: Out of 311 patients with advanced Parkinson’s disease, for 125 we proposed device-aided therapies whereas in 42 patients we increased the levodopa dose. The average levodopa doses and the administration rate were higher for the 107 patients tested for levodopa-carbidopa intestinal gel. Disease duration, mean levodopa doses and frequency of dosing were all higher in patients proposed for device-aided therapies versus patients with continued conservative treatment. Conclusion: Our patients were on lower levodopa doses (compared to literature), but the combinations were used more often. Device-aided therapies should be considered in patients with severe motor complications who receive at least 750–1000 mg levodopa daily, divided minimum 5×/day. These patients need to be tested in specialized centers by multidisciplinary teams in order to make the best decision for further action. Orv Hetil. 2019; 160(17): 662–669.

Impact of the motor complications of Parkinson's disease on the quality of life

2004 ◽  
Vol 20 (2) ◽  
pp. 224-230 ◽  
Author(s):  
Stéphane Chapuis ◽  
Lemlih Ouchchane ◽  
Olivier Metz ◽  
Laurent Gerbaud ◽  
Franck Durif
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Complications

Parkinson's disease dementia can be easily detected in routine clinical practice

2010 ◽  
Vol 25 (16) ◽  
pp. 2769-2776 ◽  
Author(s):  
Kathy Dujardin ◽  
Bruno Dubois ◽  
François Tison ◽  
Franck Durif ◽  
Isabelle Bourdeix ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Practice ◽  
Routine Clinical Practice ◽  
Parkinson’S Disease Dementia

scholarly journals Nonmotor Features in Parkinson’s Disease: What Are the Most Important Associated Factors?

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Liis Kadastik-Eerme ◽  
Mari Muldmaa ◽  
Stella Lilles ◽  
Marika Rosenthal ◽  
Nele Taba ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Cumulative Effect ◽  
Motor Complications ◽  
Nonmotor Symptoms ◽  
Wide Range ◽  
Yahr Scale

Introduction. The purpose of this study was to demonstrate the frequency and severity of nonmotor symptoms and their correlations with a wide range of demographic and clinical factors in a large cohort of patients with Parkinson’s disease (PD).Methods. 268 PD patients were assessed using the validated Movement Disorders Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), the Beck Depression Inventory (BDI), Parkinson’s Disease Questionnaire (PDQ-39), the Hoehn and Yahr scale (HY), the Schwab and England Activities of Daily Living (SE-ADL) Scale, and the Minimental State Examination (MMSE).Results. Nonmotor symptoms had a strong positive relationship with depression and lower quality of life. Also, age, duration and severity of PD, cognitive impairment, daily dose, and duration of levodopa treatment correlated with the burden of nonmotor symptoms. Patients with postural instability and gait disorder (PIGD) dominance or with the presence of motor complications had higher MDS-UPDRS Part I scores expressing the load of nonmotor features, compared to participants with other disease subtypes or without motor complications.Conclusions. Though the severity of individual nonmotor symptoms was generally rated by PD patients as “mild” or less, we found a significant cumulative effect of nonmotor symptoms on patients’ mood, daily activities, and quality of life.

Wearing-off detection in clinical practice: The wearing off real practice key (WORK-PD) study in Parkinson's disease

2015 ◽  
Vol 21 (2) ◽  
pp. 95-100 ◽  
Author(s):  
M.C. Altavista ◽  
E. Cassetta ◽  
L. Brusa ◽  
F. Viselli ◽  
A. Denaro ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Practice ◽  
Wearing Off ◽  
Real Practice
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