Characteristics of advanced Parkinson's disease patients seen in movement disorder clinics - Australian results from the cross-sectional OBSERVE study
| Autor: | David R. Williams, John D. O'Sullivan, Richard White, Andrew Evans, Rick Stell, Koray Onuk, Victor S.C. Fung, Samira Femia |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Deep brain stimulation Movement disorder clinic Parkinson's disease Device assisted therapy Referral business.industry musculoskeletal neural and ocular physiology medicine.medical_treatment General Medicine Disease medicine.disease Advanced Parkinson's disease Primary outcome Diagnosis cardiovascular system Medicine Original Article Observational study Neurology. Diseases of the nervous system RC346-429 business |
| Zdroj: | Clinical Parkinsonism & Related Disorders, Vol 4, Iss, Pp 100075-(2021) Clinical Parkinsonism & Related Disorders |
| ISSN: | 2590-1125 |
| DOI: | 10.1016/j.prdoa.2020.100075 |
| Popis: | 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. Highlights • The definition of advanced Parkinson's disease requires refinement. • Device assisted therapy is recommended in advanced Parkinson's disease. • A third of eligible patients are not receiving device assisted therapy. • Better referral and education of advanced Parkinson's disease patients is needed. |
| Databáze: | OpenAIRE |
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