Characteristics of advanced Parkinson's disease patients seen in movement disorder clinics - Australian results from the cross-sectional OBSERVE study.

Autor:	Evans A; Movement Disorders Program, Royal Melbourne Hospital, Australia., Fung VSC; Movement Disorders Unit, Department of Neurology, Westmead Hospital, Australia.; Sydney Medical School, University of Sydney, Australia., O'Sullivan JD; UQ Centre for Clinical Research, The University of Queensland, Australia.; Senior Visiting Neurologist Royal Brisbane & Women's Hospital, Australia., Stell R; Movement Disorders Clinic, Perron Institute, Australia., White R; Department of Neurology, Townsville Hospital, Australia., Williams DR; Van Cleef Roet Centre for Nervous Diseases, Australia., Femia S; Therapeutic Area Lead, AbbVie, United States of America., Onuk K; Study Designated Physician, AbbVie, United States of America.
Jazyk:	angličtina
Zdroj:	Clinical parkinsonism & related disorders [Clin Park Relat Disord] 2020 Oct 17; Vol. 4, pp. 100075. Date of Electronic Publication: 2020 Oct 17 (Print Publication: 2021).
DOI:	10.1016/j.prdoa.2020.100075
Abstrakt:	Objectives: To evaluate the proportion of Parkinson's disease (PD) patients identified as having advanced Parkinson's disease (APD) according to physician's judgement in Australia. Methods: This cross-sectional, non-interventional observational study was performed in movement disorder clinics from 18 countries. Results from Australia are presented. Participants included consecutive adults with PD attending routine clinical visits, or inpatients, who could speak English. The primary outcome was the proportion of patients diagnosed with APD via physician judgement. Results: 100 patients were recruited in Australia: 61.0% (95% CI 51.4-70.6%) diagnosed with APD by physician judgement. Patients were 66.6 ± 8.5 years, 65% were male, were living at home (97%), and diagnosed with PD for median 10.7 years (0-30.5 years). Motor fluctuations were present in 68%. For those with APD, referral was predominantly to enable access to device assisted therapies (DAT) (49%), while for non-APD, referral was largely for diagnostic purposes (41%). Patients had a median follow-up at the movement disorder clinic of 4.8 years for those with APD, or 3.6 years for non-APD. While 62% were eligible for DAT, only two-thirds of these received them. The most commonly used DAT was deep brain stimulation (64.3%). There was fair agreement between physician's judgement and the APD criteria by Delphi method (Cohen's kappa) 0.325 (95% CI 0.150-0.500) in the Australian subset. Conclusions: The definition of APD requires refinement in order to facilitate greater agreement among movement disorder specialists. A third of APD patients eligible for DAT remain untreated. Better referral and education of patients with APD is needed. Competing Interests: The design, study conduct, and financial support for the study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the publication. Andrew Evans has served on advisory boards for UCB, AbbVie, Britannia and Global Kinetics Corporation; honoraria for presentations for Stada, Lundbeck, Hospira, UCB, Teva, AbbVie and Global Kinetics Corporation; consultancy for CSL. Victor Fung receives a salary from NSW Health, has received unrestricted research grants from AbbVie and Merz, is on Advisory Boards and/or has received travel grants from AbbVie, Allergan, Ipsen, Merz, Stada, Teva and UCB, and receives royalties from Health Press Ltd. John O'Sullivan has served on advisory boards for AbbVie and STADA, has received honoraria for presentations from AbbVie, TEVA, Allergan & Ipsen and has received research funding support from AbbVie, STADA, Pfizer, TEVA, Allergan & Ipsen. Rick Stell has declared no conflict of interest. Richard White has received honoraria for presentations for AbbVie. David Williams has served on advisory boards for AbbVie and Allergan; honoraria for presentations for Stada, Lundbeck, Hospira, Teva and AbbVie; unrestricted research grants from AbbVie, Allergan, Ipsen. Samira Femia and Koray Onuk are employees of AbbVie and hold stock or stock options in AbbVie. (© 2020 Published by Elsevier Ltd.)
Databáze:	MEDLINE
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