Wearing off: A complex phenomenon often poorly recognized in Parkinson's disease. A study with the WOQ-19 questionnaire

Abstract

In clinical practice, this simple and easily administered questionnaire may be useful for the early detection of fluctuations in symptomatology in patients with PD. It will, therefore, help to improve the quality of the global care of patients with PD detected in various stages of the disease.

The Most Bothersome Aspects of Off Periods Reported by Individuals with Parkinson's Disease

“…In this analysis, we examined what aspects of off periods individuals with PD indicate as most bothersome and whether these would be captured by the WOQs, tools commonly used to screen for wearing off but also used to describe the spectrum of off symptoms in PD . In almost half of the responses, ≥1 most bothersome symptoms reported by patients would not be captured by the WOQs.…”

“…In this analysis, we examined what aspects of off periods individuals with PD indicate as most bothersome and whether these would be captured by the WOQs, tools commonly used to screen for wearing off but also used to describe the spectrum of off symptoms in PD. 2,4,11,12 In almost half of the responses, ≥1 most bothersome symptoms reported by patients would not be captured by the WOQs. Although the use of questionnaires to identify and communicate about off symptoms is seen as useful by PD patients, their care partners, and healthcare providers, 7,16 our results highlight the limitations of using lists as tools in isolation to capture the patient experience in clinical practice.…”

“…The WOQ‐32 was qualified as “suggested” as a screening tool for wearing off. However, the WOQs have been used in several studies to quantify symptom burden and examine the relationship between off symptoms, disease severity, and QOL . There are few data on the utility of the WOQs for the purpose of assessing the frequency and impact of different off symptoms.…”

“…However, the WOQs have been used in several studies to quantify symptom burden and examine the relationship between off symptoms, disease severity, and QOL. 2,4,11,12 There are few data on the utility of the WOQs for the purpose of assessing the frequency and impact of different off symptoms. The degree to which these scales capture the symptoms most bothersome to patients is also not clear.…”

Update on the Management of Parkinson’s Disease for General Neurologists

“…Some complications can be ameliorated or delayed with optimization of oral therapy Parkinson's Disease (Section 4.1) for several years until the advanced stage is reached. Levodopa-related clinical fluctuations have various clinical presentations, and very often, the nonmotor fluctuations precede and/or accompany the motor ones [23]. Among the motor fluctuations, the earliest to occur is the "wearing-off" (end of dose deterioration), which is defined as a progressive shortening of the period between dose intakes of levodopa [10] due to a progressive shortening of the "on" time duration and an earlier than previously expected "off" occurrence.…”