Requirements for Parkinson’s disease pharmacotherapy from the patients’ perspective: a questionnaire-based survey

Wüllner, Ullrich; Fuchs, Gerd; Reketat, Nicole; Randerath, O.; Kassubek, Jan

doi:10.1185/03007995.2012.702101

Cited by 16 publications

(15 citation statements)

References 22 publications

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“…In addition to caregiver and physician assessments of PD therapy, knowledge of patients' treatment needs is also an important requirement for comprehensive long-term patient care. The findings from the current study are in line with a questionnaire-based patient survey, which indicated that patients' preferred PD therapy formulations were a once daily patch or a once daily tablet 26 . Moreover, most patients rated continuous drug delivery over 24 hours, 24 hour symptom control and nondependency on meals as important properties of a PD medication 26 .…”

Section: Discussionsupporting

confidence: 83%

“…The findings from the current study are in line with a questionnaire-based patient survey, which indicated that patients' preferred PD therapy formulations were a once daily patch or a once daily tablet 26 . Moreover, most patients rated continuous drug delivery over 24 hours, 24 hour symptom control and nondependency on meals as important properties of a PD medication 26 . It is notable that similar results have been observed in terms of treatment preferences in studies of patients with Alzheimer's disease, a common neurodegenerative disorder which also requires a high level of caregiver support.…”

Section: Discussionsupporting

confidence: 83%

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Caregivers’ and physicians’ attitudes to rotigotine transdermal patch versus oral Parkinson’s disease medication: an observational study

Sieb

Themann

Warnecke

et al. 2015

Current Medical Research and Opinion

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Objective:To provide real-world data on caregiver and physician perceptions of the advantages and disadvantages of rotigotine transdermal patch (Neupro*) versus oral Parkinson's Disease (PD) medication. Methods:Cross-sectional, non-interventional study in routine clinical practice in Germany (NCT01330290). Patients had PD with documented need for care, and had received rotigotine transdermal patch as add-on to oral PD treatment for !1 month. Caregivers/nurses and physicians assessed rotigotine transdermal patch versus oral PD medications using questionnaires. Specific questions regarding the possible benefits of transdermal application were asked and comprised questions on: swallowing dysfunction, nausea/vomiting, monitoring therapy, once daily application, application independently from meals, application to sleeping patients, caregiving efforts (caregivers only) and clinical aspects (physicians only). Each question was assessed on a 5 point scale ranging from -2 (major disadvantage) to 2 (major advantage) compared with oral treatment. Primary outcomes were mean total scores of all questions for caregivers/nurses and physicians who provided responses for !4 questions. As there are no validated tools to assess physician/caregiver preference in the PD setting, there is no reference against which the current findings can be compared; this study serves to pilot the questionnaires. Results:Questionnaire responses from 128 caregivers/nurses and 41 physicians were documented for 147 patients. One hundred (68%) patients had a caregiving family member; 40 (27%) were cared for by a nurse. Mean PD duration was 8.2 (SD 6.3) years; 136 (93%) patients were taking levodopa. Mean total score of caregivers'/ nurses' questionnaires was 1.32 (SD 0.67) and of physicians' questionnaires was 1.46 (0.32) indicating a perceived advantage of rotigotine transdermal patch over oral PD therapy. Mean scores for individual questions were in the range 1.03-1.54 for caregivers/nurses and 1.15-1.87 for physicians. When given a choice about rationale to prescribe, physicians cited pharmaceutical form (patch) in 139 (95%) cases and active agent (rotigotine) in 89 (61%) cases. Conclusion:Caregivers/nurses and physicians perceived advantages with rotigotine transdermal patch compared to an oral PD medication as add-on therapy in patients with PD; advantages were observed in aspects of medical treatment as well as in everyday situations of caregiving of PD patients.*Neupro is a registered trade name of UCB

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 83%

Caregivers’ and physicians’ attitudes to rotigotine transdermal patch versus oral Parkinson’s disease medication: an observational study

Sieb

Themann

Warnecke

et al. 2015

Current Medical Research and Opinion

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“…Among the motor complications associated with levodopa therapy and disease progression early morning akinesia, which refers to the occurrence of clinically significant parkinsonism preceding the administration of the first daily dose of dopamine replacement agents, has been recently identified as a significant source of discomfort by 55.4% of 6351 respondents of an anonymous survey carried out among German PD patients [90]. A supplemental dose of levodopa taken upon awakening has been proven to be beneficial in this circumstance, with its effect shown to reach clinical significance within 15-75 minutes after drug ingestion [91].…”

Section: Wearing-offmentioning

confidence: 99%

Levodopa in the Treatment of Parkinson's Disease: Current Status and New Developments

Salat

Tolosa

2013

Journal of Parkinson's Disease

175

119

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Levodopa, a dopamine precursor, is an effective and well-tolerated dopamine replacement agent used to treat Parkinson's disease (PD). Oral levodopa has been widely used for over 40 years, often in combination with a dopa-decarboxylase inhibitor (DDCI), which reduces many treatment complications, extending its half-life and increasing levodopa availability to the brain. Entacapone, a catechol-O-methyltransferase inhibitor, can also be used to improve the bioavailability of levodopa, especially when used in conjunction with a DDCI. During early-stage PD, treatment will depend on the severity of symptoms; if greater symptomatic effect is required then levodopa or dopamine agonists are usually the drugs of choice. The ability to remain employable or physically active is an important goal in younger patients, therefore, in some instances levodopa initiation should be considered early on, either as a monotherapy or in combination with other drugs. The clinical use of levodopa may eventually be limited by the development of various treatment-related complications, including response fluctuations, dyskinesia and psychiatric problems. Motor complications are related to the intermittent delivery of dopamine-replacing drugs to the brain. Triple combination of levodopa/carbidopa/entacapone available in a single tablet in multiple levodopa dose strengths offers flexibility and helps control response fluctuations. Recent developments in treatment with levodopa try to obtain continuous delivery with levodopa and include duodenal infusion of a levodopa/carbidopa, transdermal levodopa patch, and oral pro-levodopa. Levodopa remains the most potent dopaminergic therapy for PD.

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“…Disease‐specific QoL questionnaires can, however, be relatively tautological, providing results that are difficult to interpret because of lack of external reference . Furthermore, from the patient's perspective, PD pharmacotherapy needs to address a range of symptoms, including non‐motor symptoms in addition to motor symptoms . Lastly, it is important to note that the generic HRQoL instruments in the present study were sufficiently sensitive to show some decline in HRQoL, even within the short interval of 6 months.…”

Section: Discussionmentioning

confidence: 85%

Pharmacotherapy and generic health-related quality of life in Parkinson's disease

Järvelä

Kaasinen

2015

Acta Neurol Scand

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Requirements for Parkinson’s disease pharmacotherapy from the patients’ perspective: a questionnaire-based survey

Cited by 16 publications

References 22 publications

Caregivers’ and physicians’ attitudes to rotigotine transdermal patch versus oral Parkinson’s disease medication: an observational study

Caregivers’ and physicians’ attitudes to rotigotine transdermal patch versus oral Parkinson’s disease medication: an observational study

Levodopa in the Treatment of Parkinson's Disease: Current Status and New Developments

Pharmacotherapy and generic health-related quality of life in Parkinson's disease

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