Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 151 No. 0910 (2021)

Characterisation of advanced Parkinson’s disease: OBSERVE-PD observational study – results of the Swiss subgroup

DOI
https://doi.org/10.4414/smw.2021.20419
Cite this as:
Swiss Med Wkly. 2021;151:w20419
Published
06.03.2021

Summary

AIMS OF THE STUDY

Currently, the characterisation of advanced Parkinson’s disease (APD) does not follow standardised diagnostic criteria, which complicates the evaluation of ongoing care and treatment strategies, such as eligibility for device-aided treatment (DAT). Therefore, this study aimed to determine the proportion of APD and non-advanced Parkinson’s disease (non-APD) patients treated at specialised movement disorder centres in Switzerland, to compare clinical characteristics of APD versus non-APD patients and to assess eligibility for and use of DAT. Furthermore, potential differences between the Swiss and international situation should be uncovered.

METHODS

OBSERVE-PD was a cross-sectional, international, observational study including 2615 patients from 128 movement disorder centres in 18 countries. For the Swiss subgroup of the study analysed here, which included 134 patients from 5 movement disorder centres, motor and non-motor symptoms, activities of daily living and quality of life were assessed as endpoints. The correlation between physician’s judgement of APD and the Delphi criteria for APD, which were developed by an international expert group, as well as the clinical burden in APD and non-APD patients and eligibility for and use of DAT were evaluated. The results for the Swiss subgroup were subsequently compared with the international full analysis set of the OBSERVE-PD study.

RESULTS

Based on physician’s judgement, 69.4% of patients included in the Swiss study suffered from APD. A moderate correlation between physician’s judgement and the Delphi criteria for APD was observed (Κ = 0.480, 95% confidence interval 0.317–0.642). Clinical burden was higher for APD patients, as shown by worse scores for activities of daily living, motor symptom severity, dyskinesia duration/disability, duration of “off” time, non-motor symptoms and quality of life as compared with non-APD patients (p <0.0001 for all). The Swiss data for disease burden were comparable to the international findings, except that the Swiss patients showed less “off” time. Amongst APD patients eligible for DAT, the main reason for no DAT in Switzerland was patient refusal, whereas patients needing more time to decide about it was the most frequent reason in the international analysis.

CONCLUSIONS

The study shows that the burden of APD in tertiary care centres in Switzerland is comparable to the international situation. Patient refusal is the main reason for no DAT amongst eligible APD patients in such centres. The identification of standard APD classification parameters and evaluation of the reasons for no DAT are relevant for optimising treatment strategies and the transition to DAT.

References

  1. Antonini A, Stoessl AJ, Kleinman LS, Skalicky AM, Marshall TS, Sail KR, et al. Developing consensus among movement disorder specialists on clinical indicators for identification and management of advanced Parkinson’s disease: a multi-country Delphi-panel approach. Curr Med Res Opin. 2018;34(12):2063–73. doi:.https://doi.org/10.1080/03007995.2018.1502165
  2. Clarke CE, Worth P, Grosset D, Stewart D. Systematic review of apomorphine infusion, levodopa infusion and deep brain stimulation in advanced Parkinson’s disease. Parkinsonism Relat Disord. 2009;15(10):728–41. doi:.https://doi.org/10.1016/j.parkreldis.2009.09.005
  3. Fasano A, Fung VSC, Lopiano L, Elibol B, Smolentseva IG, Seppi K, et al. Characterizing advanced Parkinson’s disease: OBSERVE-PD observational study results of 2615 patients. BMC Neurol. 2019;19(1):50–50. doi:.https://doi.org/10.1186/s12883-019-1276-8
  4. Kulisevsky J, Luquin MR, Arbelo JM, Burguera JA, Carrillo F, Castro A, et al. [Advanced Parkinson’s disease: clinical characteristics and treatment (part 1)]. Neurologia. 2013;28(8):503–21. doi:.https://doi.org/10.1016/j.nrl.2013.05.001
  5. von Campenhausen S, Bornschein B, Wick R, Bötzel K, Sampaio C, Poewe W, et al. Prevalence and incidence of Parkinson’s disease in Europe. Eur Neuropsychopharmacol. 2005;15(4):473–90. doi:.https://doi.org/10.1016/j.euroneuro.2005.04.007
  6. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17(5):427–42. doi:.https://doi.org/10.1212/WNL.17.5.427
  7. Bach JP, Riedel O, Klotsche J, Spottke A, Dodel R, Wittchen HU. Impact of complications and comorbidities on treatment costs and health-related quality of life of patients with Parkinson’s disease. J Neurol Sci. 2012;314(1-2):41–7. doi:.https://doi.org/10.1016/j.jns.2011.11.002
  8. Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, et al.; PRIAMO study group. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord. 2009;24(11):1641–9. doi:.https://doi.org/10.1002/mds.22643
  9. Benito-León J, Bermejo-Pareja F, Morales-González JM, Porta-Etessam J, Trincado R, Vega S, et al.; Neurological Disorders in Central Spain (NEDICES) Study Group. Incidence of Parkinson disease and parkinsonism in three elderly populations of central Spain. Neurology. 2004;62(5):734–41. doi:.https://doi.org/10.1212/01.WNL.0000113727.73153.68
  10. Hely MA, Morris JG, Traficante R, Reid WG, O’Sullivan DJ, Williamson PM. The sydney multicentre study of Parkinson’s disease: progression and mortality at 10 years. J Neurol Neurosurg Psychiatry. 1999;67(3):300–7. doi:.https://doi.org/10.1136/jnnp.67.3.300
  11. Muangpaisan W, Mathews A, Hori H, Seidel D. A systematic review of the worldwide prevalence and incidence of Parkinson’s disease. J Med Assoc Thai. 2011;94(6):749–55.
  12. Schuepbach WMM, Rau J, Knudsen K, Volkmann J, Krack P, Timmermann L, et al.; EARLYSTIM Study Group. Neurostimulation for Parkinson’s disease with early motor complications. N Engl J Med. 2013;368(7):610–22. doi:.https://doi.org/10.1056/NEJMoa1205158
  13. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP ; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9. doi:.https://doi.org/10.1016/j.ijsu.2014.07.013
  14. Odin P, et al. Clinical indicators of advanced Parkinson’s Disease: Evaluating diagnostic properties from retrospective analysis of multi-country, cross-sectional observational study. Presented at the 2018 International Congress of Parkinson’s Disease and Movement Disorders, 2018.
  15. Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al.; Movement Disorder Society Task Force on Rating Scales for Parkinson’s Disease. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. 2004;19(9):1020–8. doi:.https://doi.org/10.1002/mds.20213

Most read articles by the same author(s)