Nishikawa Noriko, Kogo Yuki, Ishida Takayuki, Takahashi Kazushi, Takeda Atsushi
Department of Neurology, Juntendo University School of Medicine, Bunkyo, Tokyo, Japan.
Medical Headquarters, Eisai Co., Ltd., Bunkyo, Tokyo, Japan.
Parkinsons Dis. 2025 Jul 29;2025:9526138. doi: 10.1155/padi/9526138. eCollection 2025.
There are many pharmacological treatment options beyond levodopa for Parkinson's disease (PD), with a variety of drug classes and formulations available. To achieve patient-centered care, clinicians must consider patients' backgrounds and preferences when selecting medications. To investigate medication preferences regarding efficacy, safety, dosage/formulation, and cost in Japanese PD patients. Adults (18-90 years) from the Japan Parkinson's Disease Association receiving PD medication were eligible. An online survey was conducted, involving a discrete choice experiment, which set five medication characteristics including improvement of bothersome symptoms, risk of dyskinesia, risk of side effects other than dyskinesia, dosage/formulation, and monthly out-of-pocket cost. A questionnaire about the value of efficacy and safety of PD medications was also included. In the full analysis set ( = 207), the mean age was 65.2 years, 53.1% were female, and 62.8% had wearing-off. The most impotrant characteristics of PD medications for patients were the risk of dyskinesia, improvement of bothersome symptoms, and risk of side effects other than dyskinesia. Latent class analysis identified three groups with different preferences who have varied backgrounds, such as disease severity. The three most important symptoms patients wanted to improve were moving difficulty/slow movement (79.7%), body stiffness (43.5%), and pain (42.0%). The three most important side effects patients wanted to avoid were dyskinesia (54.6%), hallucinations/visual hallucinations (19.3%), and constipation (11.6%). PD patients placed the highest importance on the risk of dyskinesia for PD medications and also efficacy. To achieve patient-centered care, clinicians should consider patients' backgrounds and preferences when selecting medications.
除左旋多巴外，帕金森病（PD）还有许多药物治疗选择，有多种药物类别和制剂可供使用。为了实现以患者为中心的护理，临床医生在选择药物时必须考虑患者的背景和偏好。旨在调查日本PD患者对疗效、安全性、剂量/制剂和成本方面的药物偏好。符合条件的是来自日本帕金森病协会正在接受PD药物治疗的18至90岁成年人。进行了一项在线调查，其中包括一个离散选择实验，该实验设定了五个药物特征，包括改善烦扰症状、异动症风险、异动症以外的副作用风险、剂量/制剂和每月自付费用。还包括一份关于PD药物疗效和安全性价值的问卷。在完整分析集（n = 207）中，平均年龄为65.2岁，53.1%为女性，62.8%有剂末现象。对患者来说，PD药物最重要的特征是异动症风险、烦扰症状的改善以及异动症以外的副作用风险。潜在类别分析确定了三组偏好不同的人群，他们具有不同的背景，如疾病严重程度。患者最希望改善的三个症状是运动困难/运动缓慢（79.7%）、身体僵硬（43.5%）和疼痛（42.0%）。患者最希望避免的三个副作用是异动症（54.6%）、幻觉/视幻觉（19.3%）和便秘（11.6%）。PD患者认为PD药物的异动症风险以及疗效最为重要。为了实现以患者为中心的护理，临床医生在选择药物时应考虑患者的背景和偏好。
