Węgrzynek-Gallina Julia, Chmiela Tomasz, Borończyk Michał, Buczek Aleksandra, Hudzińska Patrycja, Bigajski Hubert, Waksmundzki Damian, Gawryluk Justyna, Siuda Joanna
Department of Neurology, Faculty of Medical Sciences in Katowice, University Clinical Centre Prof K. Gibinski, Medical University of Silesia, 14 Medykow St. 40-752 Katowice, Poland.
Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, 45/47 Ziolowa St., 40-635 Katowice, Poland.
Medicina (Kaunas). 2024 Dec 28;61(1):27. doi: 10.3390/medicina61010027.
The rapid growth of the number of advanced Parkinson's disease (PD) patients has caused a significant increase in the use of device-aided therapies (DATs), including levodopa-carbidopa intestinal gel (LCIG) and continuous subcutaneous apomorphine infusion (CSAI). The objective of this study was to evaluate patients' satisfaction and the factors influencing preferences for CSAI and LCIG. The research focused on individuals diagnosed with advanced PD undergoing DAT at the Neurology Department of the University Hospital in Katowice. A telephone survey conducted between June and July 2024 evaluated the experiences of patients with LCIG and CSAI. The Parkinson's Disease Questionnaire (PDQ-8) and the Stress Scale for Family Caregivers (BSFC-s) were applied. Based on medical record data comprising reasons for the exclusion of individuals, disease-related and treatment data were collected. Among the original cohort of 64 patients, 50 completed the survey, including 31 who might choose between infusion therapies. The average patient ages were 70.6 ± 4.7 (CSAI) and 71.2 ± 7.2 years (LCIG), with disease durations of 15 (IQR: 12-19) and 18 (IQR: 13-19) years, respectively. LCIG patients presented higher PDQ-8 scores (20 (IQR: 13-27) vs. 13 (IQR: 6-19), = 0.008), and higher BSFC-s scores (19 (IQR: 12-21) vs. 9 (IQR: 2.5-13), = 0.011). Furthermore, significant factors influencing patient preferences included fear of surgery (75% vs. 36.8%, = 0.043) and concerns about DAT safety (83.3% vs. 47.4%, = 0.049). LCIG and CSAI therapies offer benefits and disadvantages, with safety concerns and fear of surgery seeming to be decisive in the decision-making process.
晚期帕金森病(PD)患者数量的快速增长导致包括左旋多巴 - 卡比多巴肠凝胶(LCIG)和皮下持续阿扑吗啡输注(CSAI)在内的器械辅助治疗(DATs)的使用显著增加。本研究的目的是评估患者对CSAI和LCIG的满意度以及影响偏好的因素。该研究聚焦于在卡托维兹大学医院神经科接受DAT治疗的晚期PD诊断患者。2024年6月至7月进行的电话调查评估了患者使用LCIG和CSAI的体验。应用了帕金森病问卷(PDQ - 8)和家庭照顾者压力量表(BSFC - s)。基于包含个体排除原因的病历数据,收集了疾病相关和治疗数据。在最初的64名患者队列中,50名完成了调查,其中31名可以在输注疗法之间进行选择。患者的平均年龄分别为70.6±4.7岁(CSAI)和71.2±7.2岁(LCIG),病程分别为15年(四分位间距:12 - 19年)和18年(四分位间距:13 - 19年)。LCIG患者的PDQ - 8得分更高(20(四分位间距:13 - 27)对13(四分位间距:6 - 19),P = 0.008),BSFC - s得分也更高(19(四分位间距:12 - 21)对9(四分位间距:2.5 - 13),P = 0.011)。此外,影响患者偏好的重要因素包括对手术的恐惧(75%对36.8%,P = 0.043)和对DAT安全性的担忧(83.3%对47.4%,P = 0.049)。LCIG和CSAI疗法各有优缺点,对安全性的担忧和对手术的恐惧在决策过程中似乎起决定性作用。