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
2015; Elsevier BV; Volume: 21; Issue: 10 Linguagem: Inglês
10.1016/j.parkreldis.2015.07.020
ISSN1873-5126
AutoresPer Odin, К. Ray Chaudhuri, John T. Slevin, Jens Volkmann, Erik Sveberg Dietrichs, Pablo Martínez‐Martín, Joachim K. Krauss, Tove Henriksen, Regina Katzenschlager, Angelo Antonini, Olivier Rascol, Werner Poewe,
Tópico(s)Genetic Neurodegenerative Diseases
ResumoNavigate 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 Draft guidance was presented at international/national meetings and revised based on feedback.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 (>1–2 h/day) despite optimal oral/transdermal levodopa or non-levodopa-based therapies should be referred for specialist assessment even if disease duration is 70 years who have mild or moderate cognitive impairment, severe depression or other contraindications to DBS.
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