Skip to main content
SpringerLink
Log in

Clinical variables associated with treatment changes in Parkinson’s disease: results from the longitudinal phase of the REASON study

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

Abstract

To assess over a period of 9 months in a sample of Italian Parkinson’s disease (PD) patients reasons leading the neurologist to modify dopaminergic treatment and patients’ causes of dissatisfaction with ongoing therapy. To evaluate the influence of disease severity on therapy persistence. A disease severity balanced sample of PD patients with stable anti-parkinsonian drugs (APD) treatment was enrolled and evaluated every 3 months. Patients requiring APD treatment modifications were discontinued from the study. The probability to modify APD treatment is greater for higher motor (UPDRS scores) and non-motor symptoms (NMSS score) severity. Both from neurologist’s and patient’s perspective, motor symptoms were the main determinants underlying APD treatment modifications. Non-motor symptoms were cause of dissatisfaction with ongoing APD treatment for 52 % of the patients, while only 36 % of the neurologists considered these as valid reasons for therapy change. REASON is the first study in PD patients that prospectively examined reasons driving APD treatment changes. Results show that the disease severity significantly increases the probability of APD treatment change. Patients attribute greater relevance than neurologists to non-motor symptoms as reason requiring treatment changes. This confirms that patient and neurologist perceptions only partially overlap.

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
Fig. 2

Similar content being viewed by others

References

  1. Poewe W (2009) Treatments for Parkinson disease—past achievements and current clinical needs. Neurology 72:S65–S73

    Article  CAS  PubMed  Google Scholar 

  2. Grosset D, European PD Therapy Compliance Study Group (2010) Therapy adherence issues in Parkinson’s disease. J Neurol Sci 289(1–2):115–118

    Article  PubMed  Google Scholar 

  3. Tinazzi M, Abbruzzese G, Antonini A, Ceravolo R, Fabbrini G, Lessi P, Barone P, REASON Study Group (2013) Reasons driving treatment modification in Parkinson’s disease: results from the cross-sectional phase of the REASON study. Parkinsonism Relat Disord 19:1130–1135

    Article  PubMed  Google Scholar 

  4. Gelb DJ, Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson disease. Arch Neurol 56:33–39

    Article  CAS  PubMed  Google Scholar 

  5. Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observation. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  6. Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. MovDisord 25:2649–2653

    Google Scholar 

  7. Fargel M, Grobe B, Oesterle E, Hastedt C, Rupp M (2007) Treatment of Parkinson’s disease: a survey of patients and neurologists. Clin Drug Investig 27:207–218

    Article  PubMed  Google Scholar 

  8. Tarrants ML, Denarié MF, Castelli-Haley J, Millard J, Zhang D (2010) Drug therapies for Parkinson’s disease: a database analysis of patient compliance and persistence. Am J GeriatrPharmacother 8:374–383

    CAS  Google Scholar 

Download references

Acknowledgments

This research was sponsored by a grant from Boehringer-Ingelheim. The authors meet criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE) and were fully responsible for all aspects of manuscript development. We are grateful to MediData (Modena, Italy) for data collection and statistical analysis and to Sara Rizzoli and Shalom Haggiag for help in writing the manuscript.

Ethical standards

Each patient signed written informed consent and each local institutional ethics committee approved the study.

Conflict of interest

Patrizia Lessi is an employee of Boehringer-Ingelheim. Alessandra Ori is an employee of Medidata srl. Lucia Simoni is an employee of Medidata srl. The other authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. DINOGMI, Centro Parkinson, Università degli Studi di Genova, Largo Daneo 3, 16132, Genoa, Italy

    Giovanni Abbruzzese

  2. Dipartimento di Medicina, Sezione di Neuroscienze, Università di Salerno, Via S Allende 1, 84081, Baronissi, SA, Italy

    Paolo Barone

  3. Dipartimento di Neuroscienze Azienda Ospedaliero, Universitaria Pisana, Via Roma 67, 56127, Pisa, Italy

    Roberto Ceravolo

  4. Dipartimento di Neurologia e Psichiatria, Neuromed Institute, Sapienza University of Rome, Via Atinense 18, 86077, Pozzilli, IS, Italy

    Giovanni Fabbrini

  5. Boehringer-Ingelheim Italia Spa, Milano, Via Lorenzini 8, 20139, Milan, Italy

    Patrizia Lessi

  6. MediData srl, Viale Virgilio 54/U, 41123, Modena, Italy

    Alessandra Ori & Lucia Simoni

  7. Dipartimento di Scienze Neurologiche, Neuropsicologiche, Morfologiche e Motorie, Università di Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    Michele Tinazzi

  8. Department for Parkinson’s Disease, IRCCS San Camillo, Via Alberoni 70, 30126, Venice, Italy

    Angelo Antonini

Authors
  1. Giovanni Abbruzzese
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paolo Barone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberto Ceravolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giovanni Fabbrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Patrizia Lessi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alessandra Ori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lucia Simoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michele Tinazzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Angelo Antonini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Angelo Antonini.

Additional information

On behalf of the REASON study group. The members of REASON study group are listed in “Appendix”.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 107 kb)

Appendix: The REASON study group

Appendix: The REASON study group

Steering Committee:

  • Giovanni Abruzzese, Università degli Studi di Genova, Genova

  • Angelo Antonini, Ospedale IRCCS San Camillo, Venezia Lido e Università di Padova

  • Paolo Barone, Università degli Studi di Salerno Schola Medica Salernitana, Salerno

  • Roberto Ceravolo, Ospedale Santa Chiara, Pisa

  • Giovanni Fabbrini, Sapienza Università di Roma, and Neuromed Institute, Pozzilli (IS)

  • Michele Tinazzi,Unità Operativa di Neurologia/Dipartimento di Scienze Neurologiche, Neuropsicologiche, Morfologiche e Motorie, Azienda Ospedaliera-Universitaria di Verona

Participating centres:

  • M. A. B. Melone, C. Schettino, G. Capaldo, Az. Osp.Univ. Seconda Universtà di Napoli (Napoli)

  • F. Iemolo, E. Sanzaro, Ospedale Civile R. Guzzardi (Vittoria);

  • M. G. Ceravolo, M. Capecci, E. Andrenelli, Az. Ospedali Riuniti (Ancona);

  • F. E. Pontieri, C. Pellicano, D. Benincasa, Az. Osp. Sant’Andrea (Roma);

  • G. Fabbrini, S. Pietracupa, A. Latorre, Sapienza Università di Roma;

  • G. Tedeschi, A. Tessitore, A. Giordano, Seconda Università Federico II (Napoli);

  • U. Bonuccelli, D. Frosini, F. Vanelli, Ospedale Santa Chiara (Pisa);

  • G. Comi, M. A. Volonté, F. Spagnolo, Fondazione Centro San Raffaele (Milano);

  • A. Scaglioni, G. Abrignani, Ospedale di Vaio (Fidenza);

  • G. Abbruzzese, L. Avanzino, T. Tamburini, Università degli Studi di Genova (Genova);

  • A. Antonini, S. Facchini, R. Biundo, Ospedale San Camillo (Venezia Lido);

  • M. C. Altavista, C. Roberti, Ospedale San Filippo Neri (Roma);

  • T. Avarello, Az. Osp. Riuniti Villa Sofia-Cervello (Palermo);

  • G. Bono, G. Riboldazzi, S. leva, Ospedale di Circolo e Fondazione Macchi (Varese);

  • M. Del Sette, E.Carabelli, E. Traverso, Ospedale Sant’ Andrea (La Spezia);

  • R. Michelucci, S. Nassetti, E.Pasini, Ospedale Bellaria (Bologna);

  • A. Padovani, E.Cottini, B. Bigni, Az. Osp. Spedali Civili (Brescia);

  • S. Ruggieri, N. Modugno, M. Fischetti, Istituto Mediterraneo Neuromed (Pozzilli);

  • A. Stefani, M. Pierantozzi, M. Stampanoni Bassi, Policlinico Tor Vergata (Roma);

  • M. Tinazzi, S. Ottaviani, D. Ajena, Dipartimento di Scienze Neurologiche e del movimento, Università di Verona, Italy;

  • G. Trianni, F. My, M. Caggiula, Ospedale Vito Fazzi (Lecce);

  • G. Valenti, S. Grioli, I. La Farina, Ospedale Garibaldi (Catania);

  • S. Zambito Marsala, C. Marchini, M. Gioulis, Ospedale San Martino (Belluno);

  • G. Asteggiano, M. R. L’Episcopo, E. Saracco, Ospedale San Lazzaro (Alba);

  • P. Barone, M. Picillo, M. Moccia, Università Federico II Napoli (Napoli);

  • M. Onofrj, A. Thomas, Fondazione Università Gabriele D’Annunzio (Chieti);

  • A. Denaro, Istituto Chirurgico Ortopedico Traumatologico (Latina);

  • C. Marini, F. De Santis, V. Spagnoli, Ospedale di Avezzano (Avezzano);

  • R. L’Erario, P. Passadore, Ospedale S. Maria della Misericordia (Rovigo);

  • E. Belgrado, M. Mucchiut, Az. Osp. Univ. S. Maria della Misericordia (Udine);

  • A. Priori, F. Cogiamanian, Fondazione Ospedale Maggiore Policlinico (Milano);

  • A. Marchet, Ospedale Martini (Torino)

Sponsorship:

  • BoehringerIngelheim, Milano, Italy

Project Management, Statistical Analyses and data management:

  • MediData Studi e Ricerche, Modena: G. Castegnaro, A. Ori, S. Pirondi, S. Rizzoli, B. Roncari, S. Sala, S. Sgarbi, L. Simoni, F. Trevisan, L. Zanoli.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abbruzzese, G., Barone, P., Ceravolo, R. et al. Clinical variables associated with treatment changes in Parkinson’s disease: results from the longitudinal phase of the REASON study. Neurol Sci 36, 935–943 (2015). https://doi.org/10.1007/s10072-014-2060-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-014-2060-6

Keywords

Search

Navigation