Dipartimento di Scienze Neurologiche, Neuropsicologiche, Morfologiche e Motorie, Università di Verona, Italy.
Parkinsonism Relat Disord. 2013 Dec;19(12):1130-5. doi: 10.1016/j.parkreldis.2013.08.006. Epub 2013 Aug 28.
To assess the association between clinical and socio-demographic features and anti-Parkinson drug (APD) treatment modifications in patients with PD and to describe neurologist and patient opinions regarding the need for changes in APD therapy.
Subjects with PD with stable APD treatment over ≥3 months prior to baseline were enrolled and evaluated for socio-demographic data, disability, disease severity and neurologist and patient views on the need to modify APD treatment.
775 Patients were included, 51% with Hoehn and Yahr (HY) stage 1-2 (early PD) and 49% with HY stage 2.5-4 (advanced PD). Neurologists modified APD treatment in 255 patients, 97 (25%) early PD and 158 (41%; p < 0.0001) advanced PD. APD modification was strongly associated with a low educational level and UPDRS part IV score. The most common reasons behind the APD therapy changes among neurologists were presence/worsening of motor or non-motor symptoms (88% and 37% of subjects respectively). Out of 216 patients, 92% and 51% were willing to undergo APD changes to therapy because of the presence/worsening of motor or non-motor symptoms.
Neurologist decision to change APD therapy and patients reasons for dissatisfaction with it can be prevalently attributed to the presence/worsening of motor symptoms and motor fluctuations in the advanced stages. Non-motor symptoms were considered more often by patients. The patient educational level played a key role in treatment decision.
评估临床和社会人口统计学特征与帕金森病（PD）患者抗帕金森病药物（APD）治疗改变之间的关系，并描述神经病学家和患者对改变 APD 治疗的必要性的看法。
纳入了稳定接受 APD 治疗≥3 个月的 PD 患者，并评估了其社会人口统计学数据、残疾、疾病严重程度以及神经病学家和患者对改变 APD 治疗的看法。
共纳入 775 例患者，51%为 Hoehn 和 Yahr（HY）分期 1-2 期（早期 PD），49%为 HY 分期 2.5-4 期（晚期 PD）。255 例患者的神经病学家改变了 APD 治疗方案，其中 97 例（25%）为早期 PD，158 例（41%；p<0.0001）为晚期 PD。APD 改变与低教育程度和 UPDRS 第 IV 部分评分密切相关。神经病学家改变 APD 治疗的最常见原因是运动或非运动症状的存在/恶化（分别为 88%和 37%的患者）。在 216 例患者中，92%和 51%的患者愿意改变 APD 治疗方案，因为存在/恶化的运动或非运动症状。
神经病学家改变 APD 治疗方案的决定以及患者对治疗方案不满意的原因主要归因于晚期运动症状和运动波动的存在/恶化。非运动症状更多地被患者考虑。患者的教育程度在治疗决策中起着关键作用。
