Rosqvist Kristina, Odin Per, Lorenzl Stefan, Meissner Wassilios G, Bloem Bastiaan R, Ferreira Joaquim J, Dodel Richard, Schrag Anette
Division of Neurology, Department of Clinical Sciences Lund, Faculty of Medicine Lund University Lund Sweden.
Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics Skåne University Hospital Lund Sweden.
Mov Disord Clin Pract. 2021 Mar 23;8(4):563-570. doi: 10.1002/mdc3.13186. eCollection 2021 May.
There is limited knowledge on health-related quality of life (HRQoL) in late-stage Parkinson's disease (PD).
To assess factors associated with HRQoL in patients with late-stage PD, with a focus on health care provision.
The Care of Late Stage Parkinsonism (CLaSP) project is the largest study on late-stage PD to date. The current study analyzed data of 401 patients from 6 European countries in whom HRQoL was assessed with the 8-item PD Questionnaire in patients without dementia. Factors potentially associated with HRQoL were assessed and examined in linear regression analyses.
Better HRQoL was associated with living at home, greater independence in activities of daily living (Schwab and England Scale), less severe disease (Hoehn and Yahr stage), better motor function (Unified PD Rating Scale Part III), and lower non-motor symptoms burden (Non-Motor Symptoms Scale [NMSS]) across all NMSS domains. Having a PDspecialist as physician for PD, contact with a PDnurse, and no hospital admission during the past 3 months were associated with better HRQoL, but having seen a physiotherapist or occupational therapist was associated with worse HRQoL.
The results emphasize the importance of optimizing treatment for motor and multiple non-motor symptoms to improve HRQoL in patients with late-stage PD. PD-specific health care resources, particularly PDnurses, are likely important in addressing issues to improve HRQoL in this population. Worse HRQoL in those who had recently seen a physiotherapist or occupational therapist may reflect referral based on factors not measured in this study.
关于晚期帕金森病（PD）患者健康相关生活质量（HRQoL）的了解有限。
评估晚期PD患者HRQoL的相关因素，重点关注医疗保健服务。
晚期帕金森病护理（CLaSP）项目是迄今为止关于晚期PD的最大规模研究。本研究分析了来自6个欧洲国家的401例患者的数据，对无痴呆患者使用8项帕金森病问卷评估HRQoL。在线性回归分析中评估并检验可能与HRQoL相关的因素。
更好的HRQoL与居家生活、日常生活活动能力更强（施瓦布和英格兰量表）、病情较轻（霍恩和亚尔分期）、运动功能更好（统一帕金森病评定量表第三部分）以及所有非运动症状量表（NMSS）领域的非运动症状负担更低相关。有帕金森病专科医生作为PD的主治医生、与帕金森病护士接触以及在过去3个月内未住院与更好的HRQoL相关，但看过物理治疗师或职业治疗师与更差的HRQoL相关。
结果强调了优化运动和多种非运动症状治疗以改善晚期PD患者HRQoL的重要性。针对PD的医疗保健资源，尤其是帕金森病护士，在解决改善该人群HRQoL的问题方面可能很重要。近期看过物理治疗师或职业治疗师的患者HRQoL较差，这可能反映了基于本研究未测量因素的转诊情况。
