scholarly journals Prevalence of Advanced Parkinson’s Disease in Patients Treated in the Hospitals of the Spanish National Healthcare System: The PARADISE Study

2021 ◽  
Vol 11 (12) ◽  
pp. 1557
Author(s):  
Juan Carlos Martínez-Castrillo ◽  
Pablo Martínez-Martín ◽  
Ángel Burgos ◽  
Gloria Arroyo ◽  
Natalia García ◽  
...  

Background: Advanced Parkinson’s disease (APD) has been recently defined as a stage in which certain symptoms and complications are present, with a detrimental influence on the overall patient’s health conditions and with a poor response to conventional treatments. However, historically, the term APD has been controversial, thus consequently, APD prevalence has not been previously studied. Objectives: The main objective was to determine the prevalence of APD in patients diagnosed with idiopathic PD in hospitals of the Spanish National Healthcare System. Secondary objectives were the prevalence and incidence of PD and the clinical and sociodemographic characteristics and quality of life of patients with APD or non-APD. Methods: This was a non-interventional, cross-sectional, multicenter, national study in the hospital setting. Results: The study population included 929 patients with PD (mean age 71.8 ± 10.1 years; 53.8% male) and a mean time since diagnosis of 6.6 ± 5.4 years. At the time of diagnosis, 613 patients (66.06%) reported having had premotor symptoms. The Hoehn and Yahr stage was 1 in 15.7% of the patients, 2 in 42.8%, 3 in 30.1%, 4 in 9.9%, and 5 in 1.4%; 46.9% of the patients had comorbidities (mean age-adjusted Charlson comorbidity index 3.5 ± 1.7; median 10-year survival 77%) and the mean 8-item Parkinson’s Disease Quality of Life Questionnaire was 27.8 ± 20.5. We found an APD prevalence of 38.21% (95%CI: 35.08%–41.42%), a PD prevalence of 118.4 (95%CI: 117.3–119.6), and a PD incidence of 9.4 (95%CI: 5.42–13.4) all per 100,000 population. Among the APD population, a 15.2% were receiving some form of therapy for advanced stages of the disease (deep brain stimulation, levodopa/carbidopa intestinal gel, or apomorphine subcutaneous infusion). Conclusions: The percentage of patients with APD in the hospitals of the Spanish National Healthcare System was 38.2%.

2021 ◽  
pp. 1-15
Author(s):  
Eduardo Tolosa ◽  
Georg Ebersbach ◽  
Joaquim J. Ferreira ◽  
Olivier Rascol ◽  
Angelo Antonini ◽  
...  

Background: A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice. Objective: The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers. Methods: PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI). Results: Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8% . Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6). Conclusions: The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Marcos Campos ◽  
Carlos Henrique A. de Rezende ◽  
Virgilio da C. Farnese ◽  
Carlos Henrique M. da Silva ◽  
Nívea Macedo de O. Morales ◽  
...  

Translate, culturally adapt, and validate the “Parkinson's Disease Quality of Life” (PDQL) BR, into Brazilian Portuguese. Fifty-two patients answered the PDQL-BR. Twenty-one patients answered the PDQL-BR again 14 days later. The UPDRS and HY scale was applied. Validation was evaluated using psychometric properties, checking the quality of the data, reliability, and validity. Quality of the data was evaluated based on occurrence of ceiling and floor effects. Reliability was evaluated based on: internal consistency of an item, homogeneity, and reproducibility. Validation was checked through the evaluation of convergent and discriminatory validation. There was no ceiling and floor effect. When evaluating reliability, items 20, 30, and 37 showed correlation of 0.34, 0.26, and 0.37, respectively, to your scale; the other items was higher than 0.4. The alpha Cronbach coefficient was higher than 0.7 for most domains. There was good reproducibility. There were no meaningful changes in the PDQL-BR translation and cross-cultural adaptation.


2017 ◽  
Vol 30 (5) ◽  
pp. 395 ◽  
Author(s):  
Joana Jesus-Ribeiro ◽  
Elsa Vieira ◽  
Pedro Ferreira ◽  
Cristina Januário ◽  
António Freire

Introduction: Parkinson’s disease has a significant impact in quality of life, which can be assessed with 39-item Parkinson’s Disease Questionnaire and Parkinson’s Disease Quality of Life Questionnaire. This study aimed to evaluate the reliability and validity of these scales in Portuguese patients.Material and Methods: Reliability was assessed through internal consistency (Cronbach’s alpha) and reproducibility (intraclass correlation coefficient). Regarding construct validity, we performed one-way analysis of variance across different groups according to modified Hoehn and Yahr scale. For criterion validity, we compared both scales with each other and with the Short Form 36-item Health Survey.Results: In a total of 100 patients with Parkinson’s disease, Cronbach’s alpha ranged for 39-item Parkinson’s Disease Questionnaire between 0.66 - 0.98, and for Parkinson’s Disease Quality of Life Questionnaire, between 0.78 - 0.98. Intraclass correlation coefficient for 39-item Parkinson’s Disease Questionnaire ranged between 0.49 - 0.96, and for Parkinson’s Disease Quality of Life Questionnaire, ranged between 0.65 - 0.96. Both scales showed, in general, capacity to discriminate differences among patients in the different stages of disease. The scales presented moderate to strong magnitude correlations with some Short Form 36-item Health Survey domains.Discussion: Cronbach’s alpha coefficients for most domains were satisfactory. Overall, it has been demonstrated good reproducibility, as well as construct and criterion validity.Conclusion: The Portuguese versions of both scales showed to be valid and reliable.


2020 ◽  
Vol 08 (01) ◽  
pp. 53-59
Author(s):  
Jingchao Lu

Purpose:Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an indispensable and effective surgery for patients with primary Parkinson’s disease (PD). Nonetheless, its postoperative effects can be decided by many factors including the optimal programmed stimulation parameters. In this study, we analyzed the correlation between different postoperative programmed stimulation parameters and their efficacy after STN–DBS electrode implantation in patients with PD.Methods:A total of 87 patients underwent electrode implantation and completed at least one year follow-up. Then, various combinations of stimulation parameters, including stimulus intensity, frequency, and pulse width, were examined for their effects on the clinical improvement of the patients. Improvements in motor and nonmotor symptoms were analyzed using Mini-Mental State Examination, Parkinson’s Disease Quality of Life Questionnaire-39, and Unified Parkinson’s Disease Rating Scale (UPDRS) scores before and after surgery.Results:We found significantly improved UPDRS scores, quality of life, and neuropsychiatric symptoms postoperatively considering the findings of the aforementioned stimulation parameters compared with those observed preoperatively.Conclusion:This study provides a better understanding on how programmed stimulation parameters help relieve PD symptoms and improve quality of life in patients with PD undergoing STN–DBS.


2020 ◽  
Vol 41 (10) ◽  
pp. 2929-2937 ◽  
Author(s):  
Angelo Antonini ◽  
Pietro Marano ◽  
Graziano Gusmaroli ◽  
Nicola Modugno ◽  
Claudio Pacchetti ◽  
...  

Abstract Introduction The GLORIA registry included 375 advanced Parkinson’s disease (PD) patients and evaluated the efficacy and safety of a 24-month levodopa-carbidopa intestinal gel (LCIG) treatment in routine medical care. This analysis focuses on the Italian population, 60 patients treated with LCIG in 7 specialised PD care centres. Methods Hours of “Off” and “On” time were assessed with a modified version of the Unified Parkinson’s Disease Rating Scale (UPDRS) part IV items 39 and 32. Motor fluctuations, dyskinesia, non-motor symptoms, quality of life and safety were evaluated. Results Overall, 42 (70%) out of 60 patients completed the registry. LCIG treatment reduced “Off” time (− 3.3 ± 2.7 h at month 24 (M24), P < 0.0001), increased “On” time with dyskinesia (− 2.6 ± 5.2 h at M12, P = 0.0160), and improved UPDRS II and UPDRS III total scores at M24 (− 4.5 ± 10.6, P = 0.0333 and − 4.9 ± 11.7, P = 0.0229, respectively), Non-Motor Symptom Scale (NMSS) total score (− 21.8 ± 28.5, P < 0.0001) and Parkinson’s Disease Questionnaire-8 item (PDQ-8) total score (− 12.5 ± 23.9, P = 0.0173) versus previous oral therapy. Adverse drug reactions (ADR) possibly or probably related to treatment were reported in 16 (28.6%) patients. Decreased weight (7.1%), polyneuropathy (7.1%) and abdominal pain (5.4%) were the most frequent ADRs while device malfunction (5.4%) and medical device change (5.4%) were the most reported device complaints. Conclusions LCIG improved motor fluctuations, non-motor symptoms and quality of life over 24 months while tolerability was consistent with the established safety profile.


2021 ◽  
pp. 089198872098890
Author(s):  
Rebecca Gilbert ◽  
Pravin Khemani

Advanced Parkinson’s disease (PD) often brings a set of motor and non-motor features that are particularly challenging to manage. Medication options can be limited by side-effects and quality of life can be severely affected by an accumulating burden of nonmotor symptoms. Here, we reviewed the literature and our clinical experience with the aim of providing a practical approach to the management of advanced PD. We provide guidelines for treatment of physical and neurobehavioral concerns, that occur in advanced PD.


2009 ◽  
Vol 67 (2a) ◽  
pp. 203-208 ◽  
Author(s):  
Paula Scalzo ◽  
Arthur Kummer ◽  
Francisco Cardoso ◽  
Antonio Lucio Teixeira

BACKGROUND: Depression has been proposed as a major contributor to poor quality of life (QoL) in Parkinson's disease (PD). OBJECTIVE: To evaluate the relationship between depressive symptoms and QoL in subjects with PD. METHOD: Beck Depression Inventary (BDI) was used to evaluate depressive symptoms and Parkinson's Disease Quality of Life Questionnaire (PDQ-39) to assess the perception of the QoL. RESULTS: Thirty seven patients (19 male/ 18 female) with a typical onset PD and mean disease duration of 7.7 years were studied. Higher scores on BDI correlated with poorer perception of the QoL. This association occurred at the expense of the following PDQ39 domains: mobility, activities of daily living, social support, cognition and emotional well-being dimensions. PD severity also correlated with QoL. CONCLUSION: Our study corroborates the assumption that depressive symptoms contributed significantly to QoL in PD.


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