Skip to main content

Advertisement

SpringerLink
Log in

Understanding patients’ and caregivers’ perspectives and educational needs in Parkinson’s disease: a multi-ethnic Asian study

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Introduction

Little is known regarding the educational needs and perspectives of people living with Parkinson’s disease (PD), particularly in Asia.

Objective

To assess knowledge and perceptions regarding PD in a large multiethnic urban Asian cohort of patients and caregivers.

Methods

We conducted a survey at a university hospital neurology clinic, using a novel Knowledge and Perception of Parkinson’s Disease Questionnaire (KPPDQ).

Results

The KPPDQ had satisfactory psychometric properties among patients and caregivers. Five hundred subjects were recruited with a 97% response rate (211 patients, 273 caregivers). Non-motor symptoms such as urinary problems, visual hallucinations and pain were relatively poorly recognized. Many (≈ 50–80%) respondents incorrectly believed that all PD patients experience tremor, that PD is usually familial, and that there is a cure for PD. About one-half perceived PD to be caused by something the patient had done in the past, and that PD medications were likely to cause internal organ damage. Issues of stigma/shame were relevant to one-third of patients, and 70% of patients perceived themselves to be a burden to others. Two-thirds of participants felt that PD imposed a heavy financial toll. Participants were about equally divided as to whether they would consider treatment with deep brain stimulation, tube feeding or invasive ventilation. Over three-quarters of patients expressed a preference to die at home.

Conclusions

Important knowledge gaps, misperceptions and perspectives on PD were identified, highlighting the need for further efforts to raise awareness and provide accurate information regarding PD, and to address patient’s and caregivers’ needs and preferences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. GBD 2016 Parkinson’s Disease Collaborators (2018) Global, regional, and national burden of Parkinson’s disease, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 17:939–953

    Google Scholar 

  2. Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, Obeso J, Marek K, Litvan I, Lang AE, Halliday G, Goetz CG, Gasser T, Dubois B, Chan P, Bloem BR, Adler CH, Deuschl G (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30:1591–1601

    PubMed  Google Scholar 

  3. Schapira AHV, Chaudhuri KR, Jenner P (2017) Non-motor features of Parkinson disease. Nat Rev Neurosci 18:435–450

    CAS  PubMed  Google Scholar 

  4. Chaudhuri KR, Odin P (2010) The challenge of non-motor symptoms in Parkinson’s disease. Prog Brain Res 184:325–341

    PubMed  Google Scholar 

  5. Lim SY, Tan AH, Fox SH, Evans AH, Low SC (2017) Integrating patient concerns into Parkinson’s disease management. Curr Neurol Neurosci Rep 17:3

    PubMed  Google Scholar 

  6. Prakash KM, Nadkarni NV, Lye WK, Yong MH, Tan EK (2016) The impact of non-motor symptoms on the quality of life of Parkinson’s disease patients: a longitudinal study. Eur J Neurol 23:854–860

    CAS  PubMed  Google Scholar 

  7. Dorsey ER, Sherer T, Okun MS, Bloem BR (2018) The emerging evidence of the Parkinson pandemic. J Park Dis 8(s1):S3–S8

    Google Scholar 

  8. Lim SY, Tan AH, Ahmad-Annuar A, Klein C, Tan LCS, Rosales RL et al (2019) Parkinson’s disease in the Western Pacific region. Lancet Neurol 18:865–879

    PubMed  Google Scholar 

  9. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K (2011) Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155:97–107

    PubMed  Google Scholar 

  10. Tan AH, Tan CT, Marras C, Loh KW, Wye Ho NW, Lim QH, Tan PW, Lim CC, Cheong YW, Kong ST, Schee JP, Tan KH, Soo SK, Vanderschaaf C, Lai Heong Lew S, Mahamad UA, Goh KJ, Yong HS, Lim SY (2015) Knowledge of Parkinson’s disease in a multiethnic urban Asian setting. J Park Dis 5:865–879

    Google Scholar 

  11. Verschuur CVM, Suwijn SR, Boel JA, Post B, Bloem BR, van Hilten JJ, van Laar T, Tissingh G, Munts AG, Deuschl G, Lang AE, Dijkgraaf MGW, de Haan RJ, de Bie RMA, LEAP Study Group (2019) Randomized delayed-start trial of levodopa in Parkinson’s disease. N Engl J Med 380:315–324

    CAS  PubMed  Google Scholar 

  12. Pagan FL (2012) Improving outcomes through early diagnosis of Parkinson’s disease. Am J Manag Care 18(7 Suppl):S176–S182

    PubMed  Google Scholar 

  13. van der Eijk M, Nijhuis FA, Faber MJ, Bloem BR (2013) Moving from physician-centered care towards patient-centered care for Parkinson’s disease patients. Parkinsonism Relat Disord 19:923–927

    PubMed  Google Scholar 

  14. Purks JL, Wilhelm EE, Shoulson I, Creveling J, Dorsey ER, Irony T, LoCastro T, Pagan F, Ravina B, Simuni T, Sterling M, Tariot P, Anderson KE (2017) Inaugural conference on incorporating patient-reported outcomes and patient preference information into clinical research, clinical care, and risk-benefit assessments for neurodegenerative diseases. Patient 10:541–544

    PubMed  PubMed Central  Google Scholar 

  15. Buetow SA, Martínez-Martín P, Hirsch MA, Okun MS (2016) Beyond patient-centered care: person-centered care for Parkinson’s disease. NPJ Parkinsons Dis 2:16019

    PubMed  PubMed Central  Google Scholar 

  16. Mosley PE, Moodie R, Dissanayaka N (2017) Caregiver burden in Parkinson disease: a critical review of recent literature. J Geriatr Psychiatry Neurol 30:235–252

    PubMed  Google Scholar 

  17. Hiseman JP, Fackrell R (2017) Caregiver burden and the nonmotor symptoms of Parkinson’s disease. Int Rev Neurobiol 133:479–497

    PubMed  Google Scholar 

  18. van Rumund A, Weerkamp N, Tissingh G, Zuidema SU, Koopmans RT, Munneke M, Poels PJ, Bloem BR (2014) Perspectives on Parkinson disease care in Dutch nursing homes. J Am Med Dir Assoc 15:732–737

    PubMed  Google Scholar 

  19. Bhidayasiri R, Panyakaew P, Trenkwalder C, Jeon B, Hattori N, Jagota P, Wu YR, Moro E, Lim SY, Shang H, Rosales R, Lee JY, Thit WM, Tan EK, Lim TT, Tran NT, Binh NT, Phoumindr A, Boonmongkol T, Phokaewvarangkul O, Thongchuam Y, Vorachit S, Plengsri R, Chokpatcharavate M, Fernandez HH (2020) Delivering patient-centered care in Parkinson’s disease: challenges and consensus from an international panel. Parkinsonism Relat Disord 72:82–87

    PubMed  Google Scholar 

  20. Malek N, Grosset DG (2015) Medication adherence in patients with Parkinson’s disease. CNS Drugs 29:47–53

    CAS  PubMed  Google Scholar 

  21. Jitkritsadakul O, Boonrod N, Bhidayasiri R (2017) Knowledge, attitudes and perceptions of Parkinson’s disease: a cross-sectional survey of Asian patients. J Neurol Sci 374:69–74

    PubMed  Google Scholar 

  22. Tripathi RK, Kapse SV, Potey AV (2017) Prescription pattern and awareness of disease and treatment in patients of Parkinson’s disease. Neurodegener Dis Manag 7:299–306

    PubMed  Google Scholar 

  23. Moore S, Knowles S (2006) Beliefs and knowledge about Parkinson’s disease. E-Journal Appl Psychol Clin Soc Issues 2:15–21

    Google Scholar 

  24. European Parkinson’s Disease Association (EPDA) (2009) Perceptions of Parkinson’s disease: survey executive summar. yhttp://www.oursocialmedia.com/wp-content/uploads/Parkinsons-survey-executive-summary.pdf. Accessed on April 1, (2013)

  25. Yadav R, Shukla G, Goyal V, Singh S, Behari M (2012) Knowledge of Parkinson’s disease among patients and caregivers attending movement disorder clinic at a tertiary care centre in North India. Ann Indian Acad Neurol 15(4):294–296

    PubMed  PubMed Central  Google Scholar 

  26. Boersma I, Jones J, Carter J, Bekelman D, Miyasaki J, Kutner J, Kluger B (2016) Parkinson disease patients’ perspectives on palliative care needs. What are they telling us? Neurol Clin Pract 6:209–219

    PubMed  PubMed Central  Google Scholar 

  27. Wiblin L, Durcan R, Lee M, Brittain K (2017) The importance of connection to others in QoL in MSA and PSP. Parkinsons Dis 2017:5283259

    PubMed  PubMed Central  Google Scholar 

  28. Lees AJ, Hardy J, Revesz T (2009) Parkinson’s disease. Lancet. 373(9680):2055–2066

    CAS  PubMed  Google Scholar 

  29. Sim J, Wright CC (2005) The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 85:257–268

    PubMed  Google Scholar 

  30. Lowry R Kappa as a measure of concordance in categorical sorting. 2001–2020. http://vassarstats.net/kappa.html. Accessed on multiple dates in 2019

  31. Lim SY, Tan AH (2018) Historical perspective: the pros and cons of conventional outcome measures in Parkinson’s disease. Parkinsonism Relat Disord 46(Suppl 1):S47–S52

    PubMed  Google Scholar 

  32. Politis M, Wu K, Molloy S, G Bain P, Chaudhuri KR, Piccini P (2010) Parkinson’s disease symptoms: the patient’s perspective. Mov Disord 25:1646–1651

    PubMed  Google Scholar 

  33. Silverdale MA, Kobylecki C, Kass-Iliyya L, Martinez-Martin P, Lawton M, Cotterill S, Chaudhuri KR, Morris H, Baig F, Williams N, Hubbard L, Hu MT, Grosset DG, UK Parkinson's Pain Study Collaboration (2018) A detailed clinical study of pain in 1957 participants with early/moderate Parkinson’s disease. Parkinsonism Relat Disord 56:27–32

    PubMed  PubMed Central  Google Scholar 

  34. Chaudhuri KR, Prieto-Jurcynska C, Naidu Y, Mitra T, Frades-Payo B, Tluk S, Ruessmann A, Odin P, Macphee G, Stocchi F, Ondo W, Sethi K, Schapira AH, Martinez Castrillo JC, Martinez-Martin P (2010) The nondeclaration of nonmotor symptoms of Parkinson’s disease to health care professionals: an international study using the nonmotor symptoms questionnaire. Mov Disord 25:704–709

    PubMed  Google Scholar 

  35. Lohmann K, Klein C (2008) Genetics of Parkinson disease. Continuum Lifelong Learning Neurol 14:90–113

    Google Scholar 

  36. Ascherio A, Schwarzschild MA (2016) The epidemiology of Parkinson’s disease: risk factors and prevention. Lancet Neurol 15:1257–1272

    PubMed  Google Scholar 

  37. Menza M (2000) The personality associated with Parkinson’s disease. Curr Psychiatry Rep 2:421–426

    CAS  PubMed  Google Scholar 

  38. Blauwendraat C, Nalls MA, Singleton AB (2019) The genetic architecture of Parkinson’s disease. Lancet Neurol S1474–4422(19):30287-X. https://doi.org/10.1016/S1474-4422(19)30287-X

  39. Angulo J, Fleury V, Péron JA, Penzenstadler L, Zullino D, Krack P (2019) Shame in Parkinson’s disease: a review. J Park Dis 9:489–499

    Google Scholar 

  40. Maffoni M, Giardini A, Pierobon A, Ferrazzoli D, Frazzitta G (2017) Stigma experienced by Parkinson’s disease patients: a descriptive review of qualitative studies. Parkinsons Dis 2017:7203259

    PubMed  PubMed Central  Google Scholar 

  41. Heusinkveld LE, Hacker ML, Turchan M, Davis TL, Charles D (2018) Impact of tremor on patients with early stage Parkinson’s disease. Front Neurol 9:628

    PubMed  PubMed Central  Google Scholar 

  42. Ehrt U, Broich K, Larsen JP, Ballard C, Aarsland D (2010) Use of drugs with anticholinergic effect and impact on cognition in Parkinson’s disease: a cohort study. J Neurol Neurosurg Psychiatry 81:160–165

    PubMed  Google Scholar 

  43. Zhao YJ, Tan LC, Lau PN, Au WL, Li SC, Luo N (2008) Factors affecting health-related quality of life amongst Asian patients with Parkinson’s disease. Eur J Neurol 15:737–742

    CAS  PubMed  Google Scholar 

  44. Kim R, Kim HJ, Jeon B (2018) The good, the bad, and the ugly of medical information on the internet. Mov Disord 33:754–757

    PubMed  Google Scholar 

  45. Connolly R, O'Brien T, Flaherty G (2014) Stem cell tourism: a web-based analysis of clinical services available to international travellers. Travel Med Infect Dis 12:695–701

    PubMed  Google Scholar 

  46. Gharaibeh B, Anderson JE, Deasy BM (2016) Combating the threat of stem cell tourism through patient education and government regulation. Innov Entrep Health 3:15–24

    Google Scholar 

  47. Cyranoski D (2019) The potent effects of Japan's stem-cell policies. Nature 573:482–485

    CAS  PubMed  Google Scholar 

  48. Bega D, Gonzalez-Latapi P, Zadikoff C, Simuni T (2014) A review of the clinical evidence for complementary and alternative therapies in Parkinson’s disease. Curr Treat Options Neurol 16:314

    PubMed  Google Scholar 

  49. Tan LC, Lau PN, Jamora RD, Chan ES (2006) Use of complementary therapies in patients with Parkinson’s disease in Singapore. Mov Disord 21:86–89

    PubMed  Google Scholar 

  50. Schrag A, Khan K, Hotham S, Merritt R, Rascol O, Graham L (2018) Experience of care for Parkinson’s disease in European countries: a survey by the European Parkinson’s Disease Association. Eur J Neurol 25:1410–e120

    CAS  PubMed  Google Scholar 

  51. Lewitt PA (2008) Levodopa for the treatment of Parkinson’s disease. N Engl J Med 359:2468–2476

    CAS  PubMed  Google Scholar 

  52. Fahn S (2006) A new look at levodopa based on the ELLDOPA study. J Neural Transm Suppl 70:419–426

    CAS  Google Scholar 

  53. Fox SH, Katzenschlager R, Lim SY, Barton B, de Bie RMA, Seppi K, Coelho M, Sampaio C, Movement Disorder Society Evidence-Based Medicine Committee (2018) International Parkinson and movement disorder society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson’s disease. Mov Disord 33:1248–1266

    CAS  PubMed  Google Scholar 

  54. Espay AJ, Lang AE (2017) Common myths in the use of levodopa in Parkinson disease: when clinical trials misinform clinical practice. JAMA Neurol 74:633–634

    PubMed  Google Scholar 

  55. Boersma I, Jones J, Coughlan C, Carter J, Bekelman D, Miyasaki J et al (2017) Palliative care and Parkinson’s disease: caregiver perspectives. J Palliat Med 20:930–938

    PubMed  PubMed Central  Google Scholar 

  56. Baik JS, Kim JS, Koh SB, Cho JW, Lee PH, Ma HI, Kim YJ, Ahn TB, Kim SJ, Kim YD, Choi SM, Lee HW, Kim HT (2017) Patients and their caregivers’ burdens for Parkinson’s disease in Korea. J Mov Disord 10:109–115

    PubMed  PubMed Central  Google Scholar 

  57. Castrioto A, Lhommée E, Moro E, Krack P (2014) Mood and behavioural effects of subthalamic stimulation in Parkinson’s disease. Lancet Neurol 13:287–305

    PubMed  Google Scholar 

  58. Bryant MS, Rintala DH, Graham JE, Hou JG, Protas EJ (2014) Determinants of use of a walking device in persons with Parkinson’s disease. Arch Phys Med Rehabil 95:1940–1945

    PubMed  PubMed Central  Google Scholar 

  59. Hammarlund CS, Andersson K, Andersson M, Nilsson MH, Hagell P (2014) The significance of walking from the perspective of people with Parkinson’s disease. J Park Dis 4:657–663

    Google Scholar 

  60. Kegelmeyer DA, Parthasarathy S, Kostyk SK, White SE, Kloos AD (2013) Assistive devices alter gait patterns in Parkinson disease: advantages of the four-wheeled walker. Gait Posture 38:20–24

    PubMed  Google Scholar 

  61. Liao YC, Wu YR, Tsao LI, Lin HR (2013) The experiences of Taiwanese older individuals at different stages of Parkinson disease. J Neurosci Nurs 45:370–377

    PubMed  Google Scholar 

  62. Tan MMJ, Lim EC, Nadkarni NV, Lye WK, Tan EK, Prakash KM (2019) The characteristics of patients associated with high caregiver burden in Parkinson’s disease in Singapore. Front Neurol 10:561

    PubMed  PubMed Central  Google Scholar 

  63. Kwak J, Wallendal MS, Fritsch T, Leo G, Hyde T (2014) Advance care planning and proxy decision making for patients with advanced Parkinson disease. South Med J 107:178–185

    CAS  PubMed  Google Scholar 

  64. Stavroulakis T, McDermott CJ (2016) Enteral feeding in neurological disorders. Pract Neurol 16:352–361

    PubMed  Google Scholar 

  65. Marois C, Amador MDM, Payan C, Lacomblez L, Bonnet AM, Degos B, Corvol JC, Vidailhet M, le Forestier N, Mesnage V, Grabli D (2017) Outcome of gastrostomy in parkinsonism: a retrospective study. Parkinsonism Relat Disord 43:110–113

    PubMed  Google Scholar 

  66. Moens K, Houttekier D, Van den Block L et al (2015) Place of death of people living with Parkinson’s disease: a population-level study in 11 countries. BMC Palliat Care 14:28

    PubMed  PubMed Central  Google Scholar 

  67. Snell K, Pennington S, Lee M, Walker R (2009) The place of death in Parkinson’s disease. Age Ageing 38:617–619

    PubMed  Google Scholar 

  68. Borasio GD (2013) The role of palliative care in patients with neurological diseases. Nat Rev Neurol 9:292–295

    PubMed  Google Scholar 

  69. Shaw ST, Vivekananda-Schmidt P (2017) Challenges to ethically managing Parkinson disease: an interview study of patient perspectives. J Patient Exp 4:191–196

    PubMed  PubMed Central  Google Scholar 

  70. Odin P, Chaudhuri KR, Slevin JT, Volkmann J, Dietrichs E, Martinez-Martin P et al (2015) Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson’s disease: consensus from an international survey and discussion program. Parkinsonism Relat Disord 21:1133–1144

    CAS  PubMed  Google Scholar 

  71. Lökk J (2011) Lack of information and access to advanced treatment for Parkinson’s disease patients. J Multidiscip Healthc 4:433–439

    PubMed  PubMed Central  Google Scholar 

  72. Li J, Chen D, Song W, Chen K, Cao B, Huang R, Yang R, Shang H (2014) Survey on general knowledge on Parkinson’s disease in patients with Parkinson’s disease and current clinical practice for Parkinson’s disease among general neurologists from Southwest China. Clin Neurol Neurosurg 118:16–20

    PubMed  Google Scholar 

  73. Zizzo N, Bell E, Lafontaine AL, Racine E (2017) Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson’s disease patients in a patient-centred clinic. Health Expect 20:655–664

    PubMed  Google Scholar 

  74. Nijhuis FAP, van den Heuvel L, Bloem BR, Post B, Meinders MJ (2019) The patient's perspective on shared decision-making in advanced Parkinson’s disease: a cross-sectional survey study. Front Neurol 10:896

    PubMed  PubMed Central  Google Scholar 

  75. Dorsey ER, Voss TS, Shprecher DR, Deuel LM, Beck CA, Gardiner IF, Coles MA, Burns RS, Marshall FJ, Biglan KM (2010) A U.S. survey of patients with Parkinson’s disease: satisfaction with medical care and support groups. Mov Disord 25:2128–2135

    PubMed  Google Scholar 

  76. Cohen P (1982) To be or not to be: control and balancing of type I and type II errors. Eval Program Plann 5(3):247–253

    Google Scholar 

Download references

Acknowledgements

We would like to thank Drs. Kwang Hwee Goh, Thien Thien Lim, Kenny Tan, Phaik Yee Ooi and Chiun Hian Chai for their helpful appraisal and suggestions to improve the KPPDQ.

Funding information

This work was supported by the University of Malaya Parkinson’s Disease and Movement Disorder Research Program (PV035-2017), and a donation from the family and friends of the late Mr. Rodney Cooke. These funding sources had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report and in the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Division of Neurology and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson’s & Related Disorders, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    Xing Yan Choo, Shen-Yang Lim, Yan Jing Tan, Voon Wei Yong, Jia Lun Lim, Kar Foo Lau, Jing Yi Chung, Jun Min Em, Hui Ting Tan, Jia Hwa Lim, Chong Tin Tan & Ai Huey Tan

  2. School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Kuala Lumpur, Malaysia

    Karuthan Chinna

  3. Division of Palliative Care, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    Seng Beng Tan

  4. Neurology Laboratory, University of Malaya Medical Centre, 6th Floor, South Tower, 50603, Kuala Lumpur, Malaysia

    Ai Huey Tan

Authors
  1. Xing Yan Choo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shen-Yang Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karuthan Chinna
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yan Jing Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Voon Wei Yong
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jia Lun Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kar Foo Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jing Yi Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jun Min Em
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hui Ting Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jia Hwa Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Seng Beng Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Chong Tin Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ai Huey Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ai Huey Tan.

Ethics declarations

Conflict of interest

SYL reports lecturing honoraria from Lundbeck, Medtronic, Novartis, and UCB; and consultation fees from Lundbeck. AHT reportslecturing honoraria from Novartis and Boehringer Ingelheim. The other authors have no conflicts of interest.

Ethical approval

The study was approved by the Medical Research Ethics Committee, University of Malaya Medical Centre (ID number 2018723-6507) and conducted ethically in accordance with the World Medical Association Declaration of Helsinki. Written informed consent was obtained from all subjects.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 26 kb).

ESM 2

(DOCX 57 kb).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Choo, X.Y., Lim, SY., Chinna, K. et al. Understanding patients’ and caregivers’ perspectives and educational needs in Parkinson’s disease: a multi-ethnic Asian study. Neurol Sci 41, 2831–2842 (2020). https://doi.org/10.1007/s10072-020-04396-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-020-04396-4

Keywords

Search

Navigation