Objective measurement in routine care of people with Parkinson’s disease improves outcomes
Loading...
Download
Associated Records
Authors
File Licence
Editors
Date
2018-12-01
Source Title
npj Parkinson's Disease
Journal Title
Journal ISSN
Volume Title
Publisher
NATURE PUBLISHING GROUP
Melbourne Authors
Affiliation
Florey Department of Neuroscience and Mental Health
Medicine (RMH)
Medicine (RMH)
Document Type
Journal Article
Subject Code
Citation
Farzanehfar, P., Woodrow, H., Braybrook, M., McGregor, S., Evans, A., Nicklason, F. & Horne, M. (2018). Objective measurement in routine care of people with Parkinson’s disease improves outcomes. Npj Parkinson S Disease, 4 (1), https://doi.org/10.1038/s41531-018-0046-4.
Access Status
Open Access
Access URL
Open Access URL
Open Access at PMC
Linked Resource URL
NHMRC Grant Code
ARC Grant Code
Description
Abstract
It is common in medicine to titrate therapy according to target ranges of objectively measured parameters. Objective measurement of motor function is available for Parkinson's Disease (PD), making it possible to optimise therapy and clinical outcomes. In this study, an accelerometry based measurement and predefined target ranges were used to assess motor function in a Northern Tasmania PD cohort managed by a Movement Disorder clinic. Approximately 40% (n = 103) of the total PD population participated in this study and motor scores were within target in 22%. In the 78% above target, changes in oral therapy were recommended in 74%, Advanced Therapy in 12% and treatment was contraindicated in 9%. Following changes in oral therapy, there was a further objective measurement and clinical consultation to establish whether scores had reached target range: if so subjects left the study, otherwise further changes of therapy were recommended (unless contraindications were present). Seventy-seven cases completed the study, with 48% achieving target (including 22% at outset), Advanced Therapy recommended in 19% and contraindications preventing any change in therapy in 17%. In the 43% of cases in whom oral therapy was changed, total UPDRS improved significantly (effect size = 8) as did the PDQ39 in cases reaching target. NMS Quest and MOCA scores also improved significantly. This study shows that many people in a representative cohort of PD would benefit from objective assessment and treatment of their PD features against a target.