Treatment Strategies and Quality-of-Care Indicators for Patients With Parkinson's Disease

Abstract

Droxidopa has orphan status for the treatment of orthostatic hypotension and is currently not approved for this use in the United States. Currently, donepezil is not FDA approved for treatment of dementia in patients with Parkinson's disease. While fludrocortisone has been used to treat orthostatic hypotension, it does not have FDA approval. Selegiline does have FDA approval for use as an adjunct to levodopa treatment; however, it is not approved for monotherapy to treat Parkinson's disease. Additionally, tamsulosin and terazosin are approved for the treatment of benign prostatic hyperplasia but have been used to treat urinary dysfunction, which is a symptom of prostatic hyperplasia. AcknowledgementsThe authors acknowledge Chris R. Prostko, PhD, and Joanne M. Faysal, BS, from PRIME ® (Tamarac, Florida) for their assistance with the development and revision of this supplement. Alexandria, VA 22314; 703.683.8416; 703.683.8417 (fax F a c u l t y Supplement Policy Statement Standards for Supplements to the Journal of Managed Care PharmacySupplements to the Journal of Managed Care Pharmacy are intended to support medical education and research in areas of clinical practice, health care quality improvement, or efficient administration and delivery of health benefits. The following standards are applied to all JMCP supplements to ensure quality and assist readers in evaluating potential bias and determining alternate explanations for findings and results. 1. Disclose the principal sources of funding in a manner that permits easy recognition by the reader. 2. Disclose the existence of all potential conflicts of interest among supplement contributors, including financial or personal bias. 3. Describe all drugs by generic name unless the use of the brand name is necessary to reduce the opportunity for confusion among readers. 4. Identify any off-label (unapproved) use by drug name and specific off-label indication. 5. Strive to report subjects of current interest to managed care pharmacists and other managed care professionals. 6. Seek and publish content that does not duplicate content in the Journal of Managed Care Pharmacy. 7. Subject all supplements to expert peer review. Target AudienceThe target audience for this activity is managed care pharmacists and managed care physicians. This is an applicationbased learning activity. Learning ObjectivesUpon completion of this program, participants will be able to: Funding and Original Presentation of This Learning ActivityThis supplement was sponsored by PRIME ® through an independent educational grant from Teva Neuroscience. This supplement is based on the proceedings of a satellite symposium held October 15, 2008, at the Kansas City Convention Center in Kansas City, Missouri, in conjunction with the Academy of Managed Care Pharmacy's 2008 Educational Conference, which was supported by an independent grant from Teva Neuroscience. Epidemiology and Pathophysiology of PDParkinson's disease (PD) presently affects over 1 million people in the United States. While PD can occ...

Perspectives of people with Parkinson's disease and family carers about disease management in community settings: A cross‐country qualitative study

“…13652702, 0, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jocn.16636 by Universidad Autonoma De Madrid, Wiley Online Library on [13/02/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License and families, enhance their QoL (Todorova et al, 2014), and reduce the majority of costs, which normally originate from outside the formal health care system (Chen, 2010). Collaboration between different levels (primary care, neurologists, stakeholders) and different sectors (health and social sectors, voluntary organisations, local community resources) is suggested to anticipate future health complications and improve coping skills (Fabbri et al, 2020).…”

“…• Personalised care throughout the disease journey, greater accessibility of support, comprehensive care and acknowledgment of PwPD's and family carers' own role in PD management could be advantages of this multisectoral approach according to people with Parkinson's disease and family carers from Denmark, Norway, Spain and the United Kingdom. and families, enhance their QoL (Todorova et al, 2014), and reduce the majority of costs, which normally originate from outside the formal health care system (Chen, 2010). Collaboration between different levels (primary care, neurologists, stakeholders) and different sectors (health and social sectors, voluntary organisations, local community resources) is suggested to anticipate future health complications and improve coping skills (Fabbri et al, 2020).…”

“…The complexity and progressive nature of PD are well documented. Among its consequences, non‐motor symptoms (NMS) and psychosocial needs constitute a significant burden for patients and families and are the main causes of hospital admissions and decreased quality of life (QoL) (Chen, 2010; Rutten et al, 2021). Studies concerning the economic burden of the disease highlight the increase of indirect costs (in terms of loss of productivity), intangible (psychosocial costs) and personal costs (incurred by the patient and/or their family, when there is no support from private and/or public health care), increasing from 33%–61.5% (Bovolenta et al, 2017; Yang et al, 2020).…”

“…The complexity and progressive nature of PD are well documented. Among its consequences, non-motor symptoms (NMS) and psychosocial needs constitute a significant burden for patients and families and are the main causes of hospital admissions and decreased quality of life (QoL) (Chen, 2010;Rutten et al, 2021).…”

Cholesterol and Sphingomyelin Uniquely Alter the Rate of Transthyretin Aggregation and Decrease the Toxicity of Amyloid Fibrils

“…A growing body of evidence indicates that lipids can uniquely alter the aggregation rates of amyloidogenic proteins. ,,,− For instance, Matveyenka and co-workers demonstrated that zwitterionic phosphatidylcholine (PC) could strongly inhibit insulin and lysozyme aggregation. ,, At the same time, anionic lipids, such as phosphatidylserine (PS) and cardiolipin (CL), on the contrary, accelerated the aggregation of both proteins. , It was also found that lipids not only altered the rates of protein aggregation but also uniquely modified the secondary structure of amyloid oligomers and fibrils formed in their presence. ,,, Such aggregates exerted drastically different cell toxicity compared to that of the oligomers and fibrils formed in the lipid-free environment. , For instance, insulin oligomers formed in the presence of PC were found to be significantly less toxic than protein oligomers formed in the presence of PS and CL. , However, amyloid fibrils formed by amyloid β 1–42 in the presence of CL and cholesterol (Cho) exhibited much greater cell toxicity compared to that of amyloid β 1–42 fibrils formed in the lipid-free environment . The results recently reported by Jakubec and co-workers showed that Cho strongly accelerated aggregation of α-synuclein (α-syn), a small protein that is linked to the onset and progression of Parkinson’s disease . This and other pieces of experimental evidence suggest that Cho can be an important player in the aggregation of amyloidogenic proteins .…”