Device-Aided Therapies in Parkinson’s Disease—Results from the German Care4PD Study

Abstract

Data on the use of device-aided therapies (DATs) in people with Parkinson’s disease (PwP) are scarce. Analyzing data from the Care4PD patient survey, we (1) evaluated application frequency and type of DAT in a larger, nationwide, cross-sectoral PwP sample in Germany; (2) analyzed the frequency of symptoms indicative for advanced PD (aPD) and need for DAT amongst the remaining patients and (3) compared the most bothersome symptoms and need for professional long-term care (LTC) of patients with and without suspected aPD. Data from 1269 PwP were analyzed. In total, 153 PwP (12%) received DAT, mainly deep brain stimulation (DBS). Of the remaining 1116 PwP without DAT, >50% fulfilled at least one aPD criterion. Akinesia/rigidity and autonomic problems were most bothersome for PwP with and without suspected aPD, with more tremor in the non-aPD and more motor fluctuations and falls in the aPD group. To recapitulate, the German DAT application rate is rather low, although a large proportion of PwP fulfills aPD criteria indicating a need for intensified treatment strategies. Many reported bothersome symptoms could be overcome with DAT with benefits even for LTC patients. Thus, precise and early identification of aPD symptoms (and therapy-resistant tremor) should be implemented in future DAT preselection tools and educational trainings.

Utilization of MANAGE-PD Tool in a Real-World Setting in Germany: A Cross-Sectional Study

“…In addition, symptoms may be perceived and assessed differently by physicians and patients. As a result, there may be inconsistencies in the decision-making process and delayed referral and assessment for a DAT option [8][9][10][11]. The currently available DAT treatment options include deep brain stimulation (DBS), levodopa-carbidopa intestinal gel (LCIG) infusion, levodopa-entacapone-carbidopa intestinal gel (LECIG) infusion, continuous subcutaneous apomorphine infusion (CSAI), and, most recently, subcutaneous foslevodopa/foscarbidopa infusion (LDp/CDp) [12,13].…”