Abbruzzese Giovanni, Barone Paolo, Ceravolo Roberto, Fabbrini Giovanni, Lessi Patrizia, Ori Alessandra, Simoni Lucia, Tinazzi Michele, Antonini Angelo
DINOGMI, Centro Parkinson, Università degli Studi di Genova, Largo Daneo 3, 16132, Genoa, Italy,
Neurol Sci. 2015 Jun;36(6):935-43. doi: 10.1007/s10072-014-2060-6. Epub 2015 Jan 7.
To assess over a period of 9 months in a sample of Italian Parkinson's disease (PD) patients reasons leading the neurologist to modify dopaminergic treatment and patients' causes of dissatisfaction with ongoing therapy. To evaluate the influence of disease severity on therapy persistence. A disease severity balanced sample of PD patients with stable anti-parkinsonian drugs (APD) treatment was enrolled and evaluated every 3 months. Patients requiring APD treatment modifications were discontinued from the study. The probability to modify APD treatment is greater for higher motor (UPDRS scores) and non-motor symptoms (NMSS score) severity. Both from neurologist's and patient's perspective, motor symptoms were the main determinants underlying APD treatment modifications. Non-motor symptoms were cause of dissatisfaction with ongoing APD treatment for 52 % of the patients, while only 36 % of the neurologists considered these as valid reasons for therapy change. REASON is the first study in PD patients that prospectively examined reasons driving APD treatment changes. Results show that the disease severity significantly increases the probability of APD treatment change. Patients attribute greater relevance than neurologists to non-motor symptoms as reason requiring treatment changes. This confirms that patient and neurologist perceptions only partially overlap.
为了在9个月的时间里评估意大利帕金森病（PD）患者样本中，导致神经科医生调整多巴胺能治疗的原因以及患者对当前治疗不满的原因。为了评估疾病严重程度对治疗持续性的影响。招募了一组帕金森病患者，他们接受稳定的抗帕金森病药物（APD）治疗，疾病严重程度均衡，每3个月进行一次评估。需要调整APD治疗的患者退出研究。运动（统一帕金森病评定量表评分）和非运动症状（非运动症状评分）严重程度越高，调整APD治疗的可能性越大。从神经科医生和患者的角度来看，运动症状都是APD治疗调整的主要决定因素。非运动症状是52%的患者对当前APD治疗不满的原因，而只有36%的神经科医生认为这些是治疗改变的有效理由。REASON是第一项对帕金森病患者前瞻性研究驱动APD治疗改变原因的研究。结果表明，疾病严重程度显著增加了APD治疗改变的可能性。患者比神经科医生更将非运动症状视为需要治疗改变的原因。这证实了患者和神经科医生的认知仅部分重叠。
