Impact of the motor complications of Parkinson's disease on the quality of life

Chapuis, Stéphane; Ouchchane, Lemlih; Metz, O; Gerbaud, Laurent; Durif, Franck

doi:10.1002/mds.20279

Cited by 454 publications

(348 citation statements)

References 33 publications

(38 reference statements)

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“…To compare the HRQOL of Australians with PD and people with PD from other countries, 95% CIs were constructed around the estimates. Secondary subgroup analyses were undertaken by combining the studies into five regions: North America, 3,27 South America, 12,14,15,24,29,30 Western Europe, 2,13,16,25,26,[31][32][33][34] Eastern Europe, 17,35,36 and Asia-Pacific. 4,21,22,[37][38][39][40][41] The ratings for each dimension of HRQOL by people with PD living in Australia and other countries were also examined to determine the comparability of these estimates.…”

Section: Discussionmentioning

confidence: 99%

“…Nine studies included individuals with HY stage 5 within their samples. 12,13,15,29,31,34,38,39,41 Sufficient information regarding the proportion of participants in the different HY stages was provided by seven of these studies, 12,13,15,29,34,38,41 and in these investigations individuals with HY stage 5 made up less than 5% of the total sample. Thus, the disease severity of participants with PD in other countries was comparable to that observed in our Australian sample.…”

Section: International Pd Studiesmentioning

confidence: 99%

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Health-Related Quality of Life of Australians with Parkinson Disease: A Comparison with International Studies

Soh

McGinley

Watts

et al. 2012

Physiotherapy Canada

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Purpose: This study describes the health-related quality of life (HRQOL) of Australians living with Parkinson disease (PD) and compares the findings to international reports. Methods: The Parkinson's Disease Questionnaire-39 (PDQ-39) was used to measure HRQOL in 210 individuals with PD living in Australia. In parallel, a tailored literature search identified previous studies on HROQL in people with PD. A quantitative meta-analysis with a random-effects model was used to compare the HRQOL of individuals with PD living in Australia and other countries. Results : The mean PDQ-39 summary index (SI) score for this sample of Australians with PD was 20.9 (SD 12.7). Ratings for the dimension of social support and stigma were significantly lower than ratings for bodily discomfort, mobility, activities of daily living, cognition, and emotional well-being. Comparing the Australian and international PD samples revealed a significant heterogeneity in overall HRQOL (I 2 ¼ 97%). The mean PDQ-39 SI scores for Australians were lower, indicating better HRQOL relative to samples from other countries. Conclusions: This Australian sample with PD perceived their HRQOL as poor, although it was less severely compromised than that of international samples. While further research is required, these findings can inform the clinical decision-making processes of physiotherapists.Key Words: Australia; meta-analysis; Parkinson disease; quality of life. RÉ SUMÉObjectif : Cette é tude dé crit la qualité de vie lié e à la santé (QDVS) des Australiens qui vivent avec la maladie de Parkinson (MP) et elle compare les diverses conclusions de rapports internationaux. Mé thode : Le questionnaire sur la maladie de Parkinson-39 (Parkinson's Disease Questionnaire-39, ou PDQ-39) a é té utilisé pour mesurer la qualité de vie de 210 personnes aux prises avec la maladie de Parkinson et vivant en Australie. Parallè lement, une recherche documentaire sur mesure a permis de trouver les é tudes dé jà ré alisé es sur la QVDS des personnes aux prises avec cette maladie. Une mé taanalyse quantitative avec modè le à effets alé atoires a é té utilisé e pour comparer la QVDS des individus aux prises avec la maladie de Parkinson qui vivent en Australie ou ailleurs. Ré sultats : La moyenne de l'indice global du PDQ-39 pour cet é chantillon d'Australiens atteints de la maladie de Parkinson é tait de 20,9 (é cart-type de 12,7). Les cotes en ce qui concerne le soutien social et la discrimination é taient considé rablement plus faibles que celles touchant l'inconfort physique, la mobilité , les activité s de la vie quotidienne, la cognition et le bien-ê tre affectif. La comparaison entre les é chantillons de malades australiens et ceux d'ailleurs dans le monde a ré vé lé une hé té rogé né ité considé rable dans la QVDS globale (I 2 ¼ 97%). La moyenne des IS du PDQ-39 pour les Australiens é tait moins é levé e, ce qui indique une meilleure QVDS pour les é chantillons des autres pays. Conclusions : Dans cet é chantillon australien, les personnes aux prises avec la mal...

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Section: Discussionmentioning

confidence: 99%

Section: International Pd Studiesmentioning

confidence: 99%

Health-Related Quality of Life of Australians with Parkinson Disease: A Comparison with International Studies

Soh

McGinley

Watts

et al. 2012

Physiotherapy Canada

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“…Motor fluctuations are almost invariably associated with often disabling non motor fluctuations [44]. Patient surveys consistently highlight the negative impact that being 'OFF' has on the patient [45,46], and other studies show the significant impact of motor fluctuations on patient quality of life [3,47]. In particular, the early morning OFF state is associated with significant and distressing NMS as shown in a recent multicenter survey [48] and management of this common problem remains a key unmet need.…”

Section: Management Of Motor Complicationsmentioning

confidence: 98%

Unmet needs in Parkinson's disease: New horizons in a changing landscape

Bhidayasiri

Laar

2016

Parkinsonism & Related Disorders

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a b s t r a c tThe success of levodopa and other classes of drugs have meant that most people with Parkinson's disease enjoy a good quality of life for many years. However, despite the availability of several drugs and formulations that can be used as monotherapy and in combination, there are a number of disease features that the current therapies are unable to address. The disease continues to progress despite treatment, patients suffer from a myriad of motor and non-motor symptoms, and a neuroprotective therapy is urgently required. To move forward with medical and surgical management, it is important to consider new insights that recent research offers and in this review we examine how a better understanding of the disease pathology and progression might improve and enrich our daily clinical practice. It is also timely to consider the service provision changes that will increasingly be needed to effectively manage the needs of the aging population.

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“…9,10 They are often the first manifestation of motor fluctuations and are known to have a significant negative impact on a patient's ability to undertake daily activities and on their QoL. 10 In the recent European Parkinson's Disease Association (EUROPAR) study, the prevalence and characteristics of EMO periods were investigated in a series of 320 PD patients with a mean disease duration of seven years. 9 EMO periods were found to be present in 59.7 % of patients and occurred throughout the course of the disease at all stages, in mild, moderate and severe PD patients (see Figure 1).…”

Section: Apomorphine Infusion Versus Intrajejunal Levodopa Infusionmentioning

confidence: 99%

Twenty Years of Apomorphine Therapy – How Does it Compare with Levodopa?

Lees¹,

Isaacson²

2015

European Neurological Review

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Apomorphine administered subcutaneously has provided clinicians with an effective option for the rapid resolution of the symptoms of Parkinson's disease (PD) for over a quarter of a century. It is available for use either as an intermittent injection or a continuous infusion, depending on the severity of the patient's symptoms. This satellite symposium, held during the 18th International Congress of Parkinson's Disease and Movement Disorders in Stockholm, Sweden, from 8-12 June 2014, and chaired by Professor Andrew Lees, set out to review the extensive clinical experience of subcutaneous apomorphine in the management of PD accumulated over the past 25 years. It also aimed to explore why it continues to play such a valuable therapeutic role in this setting. The presenters highlighted key clinical data demonstrating why apomorphine is an effective choice for the management of both motor and non-motor symptoms in PD. Results from the limited number of comparative studies of apomorphine continuous infusion with other therapies for complex PD suggest that it has a robust motor effect, resulting in a reduction of OFF periods comparable to that achieved with more invasive options such as intrajejunal levodopa infusion or deep brain stimulation. In a large European study, apomorphine infusion has been shown to provide similar improvements in health-related quality of life to intrajejunal levodopa infusion but with a superior side-effect profile. In addition, apomorphine infusion has demonstrated beneficial non-motor effects in PD patients and reports suggest it is associated with low rates of impulse control disorders (ICDs). The motor fluctuations that occur over time in PD patients treated with oral levodopa present a management challenge as the disease progresses. Many PD patients experience these OFF periods despite optimised oral therapy and the use of multiple medications. They are due to both end-of-dose wearing OFF and delayed time to ON (TTO). A prolonged TTO is common in PD patients who have gastroparesis (delayed gastric emptying) whereby the levodopa dose is delayed exiting the stomach and is slow in reaching its site of absorption in the small intestine. Alternative non-oral formulations that avoid the gastrointestinal route, such as subcutaneous apomorphine intermittent injection, have therefore been investigated for the relief of motor fluctuations in this setting. Interim results from the ongoing Apokyn for Motor IMProvement of Morning AKinesia Trial (AM IMPAKT) study have shown that subcutaneous apomorphine injection is a valuable treatment option in PD patients with morning akinesia. This is due to a delayed onset of levodopa dose as it produces a rapid and reliable TTO, with 95 % of patients achieving at least a 20-minute reduction in TTO and an average reduction of 40 minutes. Patients also experienced improvements in Unified Parkinson's Disease Rating Scale (UPDRS) motor score and Hoehn and Yahr stage, as well as measures of quality of life and global impression of severity.

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Impact of the motor complications of Parkinson's disease on the quality of life

Cited by 454 publications

References 33 publications

Health-Related Quality of Life of Australians with Parkinson Disease: A Comparison with International Studies

Health-Related Quality of Life of Australians with Parkinson Disease: A Comparison with International Studies

Unmet needs in Parkinson's disease: New horizons in a changing landscape

Twenty Years of Apomorphine Therapy – How Does it Compare with Levodopa?

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