Article (Scientific journals)
Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson's disease: Consensus from an international survey and discussion program
Odin, P.; Chaudhuri, K.R.; Slevin, J.T. et al.
2015In Parkinsonism and Related Disorders
Peer Reviewed verified by ORBi
 

Files


Full Text
Odin et al., Parkinsonism and Related Disorders, 2015.pdf
Publisher postprint (693.78 kB)
Request a copy

All documents in ORBilu are protected by a user license.

Send to



Details



Keywords :
Parkinson's disease; Device-aided therapies; Motor fluctuations; Dyskinesias; Non-motor symptoms
Abstract :
[en] Navigate PD was an educational program established to supplement existing guidelines and provide recommendations on the management of Parkinson's disease (PD) refractory to oral/transdermal therapies. It involved 103 experts from 13 countries overseen by an International Steering Committee (ISC) of 13 movement disorder specialists. The ISC identified 71 clinical questions important for device-aided management of PD. Fifty-six experts responded to a web-based survey, rating 15 questions as ‘critically important;’ these were refined to 10 questions by the ISC to be addressed through available evidence and expert opinion. Draft guidance was presented at international/national meetings and revised based on feedback. Key take-home points are: - Patients requiring levodopa >5 times daily who have severe, troublesome ‘off’ periods (>1e2 h/day) despite optimal oral/transdermal levodopa or non-levodopa-based therapies should be referred for specialist assessment even if disease duration is <4 years. - Cognitive decline related to non-motor fluctuationsis an indication for device-aided therapies. If cognitive impairment is mild, use deep brain stimulation (DBS) with caution. For patients who have cognitive impairment or dementia, intrajejunal levodopa infusion is considered as both therapeutic and palliative in some countries. Falls are linked to cognitive decline and are likely to become more frequent with device-aided therapies. - Insufficient control of motor complications (or drug-resistant tremor in the case of DBS) are indications for device-aided therapies. Levodopa-carbidopa intestinal gel infusions or subcutaneous apomorphine pump may be considered for patients aged >70 years who have mild or moderate cognitive impairment, severe depression or other contraindications to DBS.
Disciplines :
Neurology
Author, co-author :
Odin, P.
Chaudhuri, K.R.
Slevin, J.T.
Volkmann, J.
Dietrichs, E.
Martinez-Martin, P.
Krauss, J.K.
Henriksen, T.
Katzenschlager, R.
Antonini, A.
Rascol, O.
Poewe, W.
Krüger, Rejko ;  University of Luxembourg > Faculty of Science, Technology and Communication (FSTC) > Life Science Research Unit
National Steering Committees
More authors (4 more) Less
External co-authors :
yes
Language :
English
Title :
Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson's disease: Consensus from an international survey and discussion program
Publication date :
2015
Journal title :
Parkinsonism and Related Disorders
ISSN :
1353-8020
eISSN :
1873-5126
Publisher :
Elsevier Science
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Prof. Dr. Rejko Krueger is a co-author of this publication as a member of the National Steering Committee.
Available on ORBilu :
since 26 August 2016

Statistics


Number of views
115 (4 by Unilu)
Number of downloads
1 (1 by Unilu)

Scopus citations®
 
157
Scopus citations®
without self-citations
100
OpenCitations
 
132
WoS citations
 
143

Bibliography


Similar publications



Contact ORBilu