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Treatment of Parkinson’s Disease

A Survey of Patients and Neurologists

Clinical Drug Investigation volume 27, pages 207–218 (2007)Cite this article

Abstract

Background: The treatment of Parkinson’s disease (PD) is complex and highly individual. The choice between available treatment options depends on clinical characteristics such as the patient’s age, disease severity and presence of comorbidities, lifestyle characteristics and preferences, costs of different medications and awareness and perception of available treatment options, and education of the treating physician. The impact of PD treatment regimens on patients’ health-related quality of life (QOL) is also an important healthcare feature. The objective of the present study was to assess treatment options, treatment satisfaction and opinions about treatment improvements in patients with PD and neurologists treating the disease.

Methods: Two surveys using face-to-face interviews and an additional phone survey were carried out in the US and five European countries (France, Germany, Italy, Spain and the UK). Patients with early and advanced stages of PD were included. To participate in the neurologist survey, neurologists were required to personally treat ten or more PD patients per month, including both early and advanced stage patients. Interviews consisted of a mix of closed and open-ended questions; some of these questions involved show cards.

Results: Of the 500 patients who were surveyed, 49% had early and 51% had advanced PD. Early-stage PD patients, both in the US and Europe, take a mean of 3.2 tablets daily of PD-medication. In contrast, the mean daily tablet load of PD medication is much higher for advanced-stage patients (9.9 and 8.4 tablets in the US and Europe, respectively). Tablet load was perceived as a major problem; the majority of patients wished to see improvements regarding daily medication intake and expressed interest in other delivery systems such as patches. Overall, patients rated their treatment with a score of 6.6 points (6.7 for early-stage and 6.6 for advanced-stage patients) [scale of 1–10; 10 being highest]. Physicians (n = 592) were satisfied with a number of current PD medications and assumed they improve the QOL of the patients. They regarded efficacy and safety as the most important features for the improvement of PD medication.

Conclusion: Further research is needed into PD treatment options not only for symptom alleviation but for better delivery systems that could improve compliance and QOL for patients with PD. Treatment guidelines need to incorporate QOL aspects and general communication between the health professional and the patient.

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References

  1. Schapira AHV. Science, medicine, and the future. Parkinson’s disease. BMJ 1999 Jan; 318: 311–4

    PubMed  Article  CAS  Google Scholar 

  2. de Rijk MC, Launer LJ, Berger K, et al. Prevalence of Parkinson’s disease in Europe: a collaborative study of population-based cohorts. Neurology 2000 June; 54(11) (Suppl 5): S21–3

    PubMed  Article  Google Scholar 

  3. Van den Eeden SK, Tanner CM, Bernstein AL, et al. Incidence of Parkinson’s disease: variation by age, gender, and race/ethnicity. Am J Epidemiol 2003; 157(11): 1015–22

    Article  Google Scholar 

  4. Wooten GF, Currie LJ, Bovbjerg VE, et al. Are men at greater risk for Parkinson’s disease than women? J Neurol Neurosurg Psychiatry 2004; 75: 637–9

    PubMed  Article  CAS  Google Scholar 

  5. Menken M, Munsat TL, Toole JF. The global burden of disease study: implications for neurology. Arch Neurol 2000; 57: 418–20

    PubMed  Article  CAS  Google Scholar 

  6. Huse DM, Schulman K, Orsini L, et al. Burden of illness in Parkinson’s disease. Mov Disord 2005; 20(11): 1449–54

    PubMed  Article  Google Scholar 

  7. Lindgren P, von Campenhausen S, Spottke E, et al. Cost of Parkinson’s disease in Europe. Eur J Neurol 2005; 12Suppl. 1: 68–73

    PubMed  Article  Google Scholar 

  8. Olanow CW, Jankovic J. Neuroprotective therapy in Parkinson’s disease and motor complications: a search for a patho-genesis-targeted, disease-modifying strategy. Mov Disord 2005; 20Suppl. 11: S3–10

    PubMed  Article  Google Scholar 

  9. Rascol O, Goetz C, Koller W, et al. Treatment interventions for Parkinson’s disease: an evidence based assessment. Lancet 2002 May; 359: 1589–98

    PubMed  Article  Google Scholar 

  10. Olanow CW, Watts RL, Koller WC. An algorithm (decision tree) for the management of Parkinson’s disease (2001): treatment guidelines. Neurology 2001 Jun; 56(11 Suppl. 5): Sl–88

    Google Scholar 

  11. Miyasaki JM, Martin W, Suchowersky O, et al. Practice parameter: initiation of treatment for Parkinson’s disease. An evidence-based review. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2002 Jan; 58(1): 11–7

    PubMed  Article  CAS  Google Scholar 

  12. Deutsche Gesellschaft für Neurologie. Updated guideline for Parkinson syndrome (in German) [online]. Available from URL: http://www.dgn.Org/221.0.html [Accessed 2005 Nov 17]

  13. Italian Neurological Society/Italian Society of Clinical Neurophysiology. Guidelines for the treatment of Parkinson’s disease 2002: treatment of Parkinson’s disease. Neurol Sci 2003 Jun; 24Suppl. 3: S165–213

    Google Scholar 

  14. Federation Française de Neurologie. Recommendations of the jury on diagnosis and treatment of Parkinson’s disease (short text). Rev Neurol (Paris) 2000; 156 (Suppl. 2, Part 2): 274–80

  15. Grupo de estudio de los trastomos del movimiento. Guías de práctica clínica en le enfermedad de Parkinson (in Spanish). Neurologia 1999; 14Suppl. 5: 1–92

    Google Scholar 

  16. National Institute for Health and Clinical Excellence. Parkinson’s disease: diagnosis and management in primary and secondary care. NICE full guideline, 2006 June [online]. Available from URL: http://www.nice.org.uk/page.aspx?.o=cg035 fullguideline [Accessed 2006 July 7]

  17. Bhatia K, Brooks DJ, Burn DJ, et al. Updated guidelines for the management of Parkinson’s disease. Hosp Med 2001 Aug; 62(8): 456–70

    PubMed  CAS  Google Scholar 

  18. Chase TN. The significance of continuous dopaminergic stimulation in the treatment of Parkinson’s disease. Drugs 1998; 55Suppl. 1: 1–9

    PubMed  Article  Google Scholar 

  19. Goetz CG, Koller WC, Poewe W, et al. Management of Parkinson’s disease: an evidence-based review. Mov Disord 2002 Jul/Aug; 17(Suppl. 4): S1–166

    Google Scholar 

  20. Kuopio A-M, Marttila RJ, Helenius H, et al. The quality of life in Parkinson’s disease. Mov Disord 2000; 15(2): 216–23

    PubMed  Article  CAS  Google Scholar 

  21. Schrag A, Jahanshahi M, Quinn N. What contributes to quality of life in patients with Parkinson’s disease? J Neurol Neurosurg Psychiatry 2000; 69: 308–12

    PubMed  Article  CAS  Google Scholar 

  22. The Global Parkinson’s Disease Survey Steering Committee. Factors impacting on quality of life in Parkinson’s disease: results from an international survey. Mov Disord 2002; 17(1): 60–7

    Article  Google Scholar 

  23. Zach M, Friedman A, Slawek J, et al. Quality of life in Polish patients with long-lasting Parkinson’s disease. Mov Disord 2004; 19(6): 667–72

    PubMed  Article  Google Scholar 

  24. Grosset KA, Grosset DG. Patient-perceived involvement and satisfaction in Parkinson’s disease: effect on therapy decisions and quality of life. Mov Disord 2005; 20(5): 616–9

    PubMed  Article  Google Scholar 

  25. Behari M, Srivastava AK, Pandey RM. Quality of life in patients with Parkinson’s disease. Parkinsonism Relat Disord 2005; 11: 221–6

    PubMed  Article  CAS  Google Scholar 

  26. Möller JC, Körner Y, Dodel RC, et al. Pharmacotherapy of Parkinson’s disease in Germany. J Neurol 2005 Aug; 252(8): 926–35

    PubMed  Article  Google Scholar 

  27. The Harris Poll. The difficult lives of patients with Parkinson’s disease. Health Care News (Taylor H, Leitman R, eds) 2003; 3: 15

  28. Findley LJ, Baker MG. Treating neurodegenerative diseases: what patients want is not what doctors focus on. BMJ 2002 Jun; 324: 1466–7

    PubMed  Article  Google Scholar 

  29. Shimbo T, Goto M, Morimoto T, et al. Association between patient education and health-related quality of life in patients with Parkinson’s disease. Qual Life Res 2004; 13: 81–9

    PubMed  Article  CAS  Google Scholar 

  30. O’Maley K, O’Sullivan J, Wollin J, et al. Teaching people with Parkinson’s disease about their medication. Nursing Older People 2005 Mar; 17(1): 14–20

    PubMed  Google Scholar 

  31. Weiss M, Britten N. What is concordance? Pharm J 2003 Oct; 271: 493

    Google Scholar 

  32. Ravina BM, Fagan SC, Hart RG, et al. Neuroprotective agents for clinical trials in Parkinson’s disease: a systematic assessment. Neurology 2003; 60: 1234–40

    PubMed  Article  CAS  Google Scholar 

  33. Kornick CA, Santiago-Palma J, Moryl N, et al. Benefit-risk assessment of transdermal fentanyl for the treatment of chronic pain. Drug Saf 2003; 26(13): 951–73

    PubMed  Article  CAS  Google Scholar 

  34. The Parkinson Study Group. A controlled trial of rotigotine monotherapy in early Parkinson’s disease. Arch Neurol 2003; 60: 1721–8

    Article  Google Scholar 

  35. Watts RL, Jankovic J, Waters C, et al. Randomized, blind, controlled trial of transdermal rotigotine in early Parkinson disease. Neurology 2007; 68: 272–76

    PubMed  Article  CAS  Google Scholar 

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Acknowledgements

All results described in this publication were obtained via market research studies conducted by Psyma International Medical Marketing Research GmbH and Prophares International AG and funded by Schwarz Pharma. The authors are employees of these companies.

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Affiliations

  1. Psyma International Medical Marketing Research GmbH, Rückersdorf, Germany

    Matthias Fargel

  2. Prophares International AG [formerly I+G Suisse], Basel, Switzerland

    Bernd Grobe

  3. SCHWARZ PHARMA, Alfred-Nobel-Strasse 10, 40789, Monheim, Germany

    Eberhard Oesterle, Claudia Hastedt &  Markus Rupp

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  1. Matthias Fargel
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  2. Bernd Grobe
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  3. Eberhard Oesterle
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  4. Claudia Hastedt
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  5. Markus Rupp
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Correspondence to Markus Rupp.

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Fargel, M., Grobe, B., Oesterle, E. et al. Treatment of Parkinson’s Disease. Clin. Drug Investig. 27, 207–218 (2007). https://doi.org/10.2165/00044011-200727030-00004

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Keywords

  • Levodopa
  • Dopamine Agonist
  • Pramipexole
  • Cabergoline
  • Ropinirole