title: Treatment of Parkinson's disease: a survey of patients and neurologists.
abstract: BACKGROUND
  The treatment of Parkinson's disease (PD) is complex and highly individual. The choice between available treatment options depends on clinical characteristics such as the patient's age, disease severity and presence of comorbidities, lifestyle characteristics and preferences, costs of different medications and awareness and perception of available treatment options, and education of the treating physician. The impact of PD treatment regimens on patients' health-related quality of life (QOL) is also an important healthcare feature. The objective of the present study was to assess treatment options, treatment satisfaction and opinions about treatment improvements in patients with PD and neurologists treating the disease.
  
  
  METHODS
  Two surveys using face-to-face interviews and an additional phone survey were carried out in the US and five European countries (France, Germany, Italy, Spain and the UK). Patients with early and advanced stages of PD were included. To participate in the neurologist survey, neurologists were required to personally treat ten or more PD patients per month, including both early and advanced stage patients. Interviews consisted of a mix of closed and open-ended questions; some of these questions involved show cards.
  
  
  RESULTS
  Of the 500 patients who were surveyed, 49% had early and 51% had advanced PD. Early-stage PD patients, both in the US and Europe, take a mean of 3.2 tablets daily of PD-medication. In contrast, the mean daily tablet load of PD medication is much higher for advanced-stage patients (9.9 and 8.4 tablets in the US and Europe, respectively). Tablet load was perceived as a major problem; the majority of patients wished to see improvements regarding daily medication intake and expressed interest in other delivery systems such as patches. Overall, patients rated their treatment with a score of 6.6 points (6.7 for early-stage and 6.6 for advanced-stage patients) [scale of 1-10; 10 being highest]. Physicians (n = 592) were satisfied with a number of current PD medications and assumed they improve the QOL of the patients. They regarded efficacy and safety as the most important features for the improvement of PD medication.
  
  
  CONCLUSIONS
  Further research is needed into PD treatment options not only for symptom alleviation but for better delivery systems that could improve compliance and QOL for patients with PD. Treatment guidelines need to incorporate QOL aspects and general communication between the health professional and the patient.
authors.affiliation: Psyma International Medical Marketing Research GmbH, Rückersdorf, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Fargel
authors.forename: Bernd
authors.initials: B
authors.lastname: Grobe
authors.forename: Eberhard
authors.initials: E
authors.lastname: Oesterle
authors.forename: Claudia
authors.initials: C
authors.lastname: Hastedt
authors.forename: Markus
authors.initials: M
authors.lastname: Rupp
mesh_terms: D000978:Antiparkinson Agents / Q000145:classification / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review / Q000379:methods / Q000706:statistics & numerical data; D005060:Europe; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D009462:Neurology / Q000706:statistics & numerical data*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000473:pathology; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010361:Patients / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States
chemical_list: D000978:Antiparkinson Agents