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Bhanupriya R, Haridoss M, Lakshmi GS, Bagepally BS. Health-related quality of life in Parkinson's disease: systematic review and meta-analysis of EuroQol (EQ-5D) utility scores. Qual Life Res 2024; 33:1781-1793. [PMID: 38581635 DOI: 10.1007/s11136-024-03646-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Evaluating the Health-related quality of life (HRQoL) of individuals with Parkinson's disease (PD) holds significant importance in clinical and research settings. The EQ-5D is a widely recognized tool for comprehensive measurement of HRQoL using utility values. This study aims to systematically review and synthesize EQ-5D utility values from existing literature on patients with PD and their caregivers. METHODS We conducted a systematic search for studies that provided EQ-5D utility scores for patients with PD, using PubMed-Medline, Scopus, and Embase and selected the studies. The selected studies underwent systematic review, including an assessment of their quality. We performed a meta-analysis using a random-effect model and conducted a meta-regression analysis to investigate sources of heterogeneity among the studies. RESULTS The search result of 13,417 articles that were reviewed, 130 studies with 33,914 participants were selected for systematic review, and 79 studies were included for meta-analysis. The pooled EQ-5D utility values and visual analog score (VAS) among PD were 62.72% (60.53-64.93, I2 = 99.56%) and 0.60 (0.55-0.65, I2 = 99.81%), respectively. The pooled scores for caregivers' EQ-VAS and EQ-5D utility were 70.10% (63.99-76.20, I2 = 98.25%) and 0.71 (0.61-0.81, I2 = 94.88%), respectively. Disease duration (P < 0.05) showed a negative correlation with EQ-5D utility values on meta-regression. CONCLUSION The pooled utility values of PD and their caregivers help to understand their HRQoL and aid in conducting health economics research. The negative association between disease duration and utility values highlights the evolving nature of HRQoL challenges, suggesting the need for appropriate long-term disease management.
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Affiliation(s)
| | | | | | - Bhavani Shankara Bagepally
- ICMR-National Institute of Epidemiology, Chennai, India.
- Health Technology Assessment Resource Centre ICMR-NIE, ICMR-National Institute of Epidemiology, Ayapakkam, Chennai, 600077, India.
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Wang Y, Xu J, Xie T. Relationship between internet use intensity and quality of life in chronic patients during the COVID-19 pandemic: The role of physical exercise and health insurance. Front Public Health 2022; 10:947465. [PMID: 36187609 PMCID: PMC9523425 DOI: 10.3389/fpubh.2022.947465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/08/2022] [Indexed: 01/21/2023] Open
Abstract
The internet use intensity of human has increased substantially during the COVID-19 Pandemic, and it is severely impacting the well-being of chronic patients. This study aimed to explore the underlying mechanism of the relationship between internet use intensity and quality of life in chronic patients, based on the cross-sectional data from China Family Panel Studies (CFPS) during the COVID-19 Pandemic in 2020. The results showed that the internet use intensity had significant positive association with quality of life among chronic patients, and such association has been found in both urban and rural samples. Among the relationship of internet use intensity and quality of life in chronic patients, the mediating effect of physical exercise reached 10.25%. Furthermore, health insurance positively moderated this relationship. There are new insights for policy recommendations and clinical guidance on the role of physical activity and health insurance aimed at improving chronic patients' quality of life. Meanwhile, in both rural and urban governance, public health agencies should promote the "Internet + Healthcare" program to improve health insurance and physical activity literacy, thus providing a higher level of quality of life for patients with chronic diseases during the COVID-19 Pandemic.
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Affiliation(s)
- Yangyang Wang
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Xu
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China,School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Tian Xie
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Tian Xie
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Müller T. Perspective: cell death mechanisms and early diagnosis as precondition for disease modification in Parkinson's disease: are we on the right track? Expert Rev Mol Diagn 2022; 22:403-409. [PMID: 35400295 DOI: 10.1080/14737159.2022.2065198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Current research paradigms on biomarkers for chronic neurodegenerative diseases, such as Parkinson's disease, focus on identification of reliable, easy-to-apply tools for diagnostic screening and progression assessment. AREAS COVERED This perspective discusses possible misconceptions of biomarker research in chronic neurodegeneration from a clinician's view based on a not systematic literature search. Multifactorial disease triggers, heterogeneity of symptom and their progression are main reasons for the still missing availability of biomarkers. EXPERT OPINION Onset of chronic neurodegenerative disease entities may probably result from a decompensated endogenous repair machinery in the central nervous system, for example the neogenin receptor associated repulsive guidance molecule pathway. Future clinical research is warranted on these repair structures and aim to identify markers for the imbalance between damage and repair, which hypothetically contributes to generation of disease. An assignment to a specific chronic neurodegenerative disease entity probably appears to be secondary. Decryption of probable molecular signals of an impaired repair potential will enable an earlier diagnosis, better monitoring of disease progress and of treatment response. This concept will hopefully provide better preconditions for prevention, cure or therapeutic beneficial disease modification. These unmet therapeutic needs may be achieved for example via antagonism of repulsive guidance molecule A.
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Affiliation(s)
- Thomas Müller
- Department of NeurologySt. Joseph Hospital Berlin-Weißensee, Gartenstr.1 Berlin, Germany
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Mahato SKS, Apidechkul T, Sriwongpan P, Hada R, Sharma GN, Nayak SK, Mahato RK. Factors associated with quality of life among chronic kidney disease patients in Nepal: a cross-sectional study. Health Qual Life Outcomes 2020; 18:207. [PMID: 32600360 PMCID: PMC7325283 DOI: 10.1186/s12955-020-01458-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background Chronic kidney disease (CKD) leads to decreased quality of life (QOL) by increasing the risk of death during the progression of its pathogenesis. However, many factors can be improved to support QOL. This study aimed to assess QOL among CKD patients in Nepal and to determine the factors associated with their QOL. Method A cross-sectional study was used for data collection. CKD cases receiving medical attention in the Bir Hospital in Mahaboudh, Kathmandu; Tribhuvan University Teaching Hospital in Maharajgunj, Kathmandu; Sumeru Hospital in Dhapakhel, Lalitpur; and Shahid Dharma Bhakta National Transplant Centre in Bhaktapur between August and October 2019 were invited to participate in the study. A validated questionnaire and the kidney disease quality of life short form (KDQOL-SF™ 1.3) were used to assess QOL. A questionnaire was completed by the researcher in face-to-face interviews. Logistic regression was used to detect the associations between variables at the significance level of α = 0.05. Results A total of 440 participants were recruited into the study: 56.59% were males, 74.32% were aged between 31 and 70 years, 25.68% were illiterate, and 82.95% were unemployed. The prevalence of good QOL among CKD in the domains of the physical component summary (PCS), mental component summary (MCS), and kidney disease component summary (KDCS) with and without hemodialysis were 53.64, 22.05, 21.28, and 13.19%, respectively. After controlling for all potential confounding factors, eight variables were found to be associated with good QOL in the domain of PCS: age, education, stage of CKD, hemodialysis, transporting oneself to a hospital, health insurance, medical expenses, and perceived lack of difficulty in handling medical expenses. Six variables were associated with good QOL in the domain of MCS after controlling for all potential confounding factors: residence, stage of CKD, transporting oneself to a hospital, health insurance, medical expenses, and perceived lack of difficulty in handling medical expenses. Conclusions Public health interventions should be developed and implemented to improve QOL among CKD patients in Nepal by focusing on older female patients who have low education, live in rural areas and no health insurance.
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Affiliation(s)
- Shambhu Kumar Saxena Mahato
- School of Health Science, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province, Thailand.,Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province, Thailand. .,Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province, Thailand.
| | - Pamornsri Sriwongpan
- School of Health Science, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province, Thailand
| | - Rajani Hada
- Department of Nephrology, National Academy of Health Sciences, Bir Hospital, Mahaboudh, Kathmandu, Nepal
| | | | | | - Ram Kumar Mahato
- Ministry of Health and Population, Ramshah Path, Kathmandu, Nepal
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Benefit on motor and non-motor behavior in a specialized unit for Parkinson's disease. J Neural Transm (Vienna) 2017; 124:715-720. [PMID: 28247031 DOI: 10.1007/s00702-017-1701-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/21/2017] [Indexed: 10/20/2022]
Abstract
Treatment of patients with Parkinson's disease in specialized units is quite common in Germany. Data on the benefit of this hospitalization of patients with Parkinson's disease on motor and non-motor symptoms in conjunction with standardized tests are rare. Objective was to determine the efficacy of this therapeutic setting. We scored disease severity and performed clinical tests, respectively, instrumental procedures under standardized conditions in consecutively referred in-patients initially and at the end of their hospital stay. There was a decrease of motor and non-motor symptoms. The extent of improvement of non-motor and motor symptoms correlated to each other. Performance of complex movement sequences became better, whereas execution of simple movement series did not ameliorate. The interval for the timed up and go test went down. We demonstrate the effectiveness of an in-patient stay in a specialized unit for Parkinson's disease. Objective standardized testing supplements subjective clinical scoring with established rating scales.
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Prakash KM, Nadkarni NV, Lye WK, Yong MH, Tan EK. The impact of non-motor symptoms on the quality of life of Parkinson's disease patients: a longitudinal study. Eur J Neurol 2016; 23:854-60. [DOI: 10.1111/ene.12950] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/13/2015] [Indexed: 11/26/2022]
Affiliation(s)
- K. M. Prakash
- Department of Neurology; Singapore General Hospital; Singapore Singapore
- Department of Neurology; National Neuroscience Institute; Singapore Singapore
- Duke − NUS Graduate Medical School; Singapore Singapore
| | - N. V. Nadkarni
- Centre for Quantitative Medicine; Duke − NUS Graduate Medical School; Singapore Singapore
| | - W.-K. Lye
- Centre for Quantitative Medicine; Duke − NUS Graduate Medical School; Singapore Singapore
| | - M.-H. Yong
- Department of Neurology; Singapore General Hospital; Singapore Singapore
| | - E.-K. Tan
- Department of Neurology; Singapore General Hospital; Singapore Singapore
- Department of Neurology; National Neuroscience Institute; Singapore Singapore
- Duke − NUS Graduate Medical School; Singapore Singapore
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Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease and pathologically is characterised by a progressive loss of dopaminergic cells of the nigrostriatal pathway. Clinically, PD is mainly defined by the presence of the motor symptoms of bradykinesia, rigidity, rest tremor and postural instability, but non-motor symptoms such as depression, dementia and autonomic disturbances are recognised as integral parts of the disease. Although pharmacotherapy for PD was introduced almost 50 years ago, and has improved significantly over the intervening period, the timing of initiation of treatment in newly diagnosed PD remains controversial. While some physicians favour an early start of pharmacotherapy at or soon after diagnosis, others prefer to delay pharmacological treatment until a certain degree of disability has developed. This article aims to discuss the advantages and disadvantages of both strategies by exploring their effects on symptoms, disease progression and quality of life. Although the data on putative disease-modifying effects of early pharmacological intervention in PD are still inconclusive, we believe that the most important indication for an early initiation of anti-parkinsonian treatment should be to maintain the quality of life of PD patients and to secure their socioeconomic status as long as possible.
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Prakash KM, Nadkarni NV, Lye WK, Yong MH, Chew LM, Tan EK. A longitudinal study of non-motor symptom burden in Parkinson's disease after a transition to expert care. Parkinsonism Relat Disord 2015; 21:843-7. [PMID: 25997863 DOI: 10.1016/j.parkreldis.2015.04.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 04/12/2015] [Accepted: 04/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Non-motor symptoms (NMS) are common among patients with Parkinson's disease (PD) however little is known about their progression in terms of severity or burden after referral to expert care. OBJECTIVE This study was aimed to establish the progression of NMS burden in PD patients after referral to tertiary healthcare centre and factors affecting it. METHODS Newly referred PD patients were prospectively enrolled and follow-up for up to 18 months. Non-motor symptoms scale (NMSS) was used to evaluate the burden of non-motor symptoms. RESULTS There was a significant median reduction of total NMS burden over the follow-up period. Similarly all NMS domains except domains 2 (sleep/fatigue), 3 (mood/cognition), 6 (gastrointestinal) and 7 (urinary) showed significant median reduction of scores. In the univariate regression analysis, Hoehn & Yahr staging, disease duration, visit, Schwab & England Activities of Daily Living score and UPDRS motor scores were individually predictive of change in total NMS burden. However, in the multivariable regression analysis only the latter three were significantly predictive of change in the total NMS burden. CONCLUSION There was a significant reduction of total NMS burden over the study period. The severity of motor and activity of daily living impairments as well as subsequent visit were the best predictors of NMS change.
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Affiliation(s)
- Kumar M Prakash
- Department of Neurology, Singapore; Singapore General Hospital, Singapore; National Neuroscience Institute, Singapore; Duke-NUS Graduate Medical School, Singapore.
| | - Nivedita V Nadkarni
- Centre for Quantitative Medicine, Singapore; Duke-NUS Graduate Medical School, Singapore
| | - Weng-Kit Lye
- Centre for Quantitative Medicine, Singapore; Duke-NUS Graduate Medical School, Singapore
| | - Ming-Hui Yong
- Department of Neurology, Singapore; Singapore General Hospital, Singapore
| | - Lai-Mun Chew
- Department of Neurology, Singapore; Singapore General Hospital, Singapore; National Neuroscience Institute, Singapore
| | - Eng-King Tan
- Department of Neurology, Singapore; Singapore General Hospital, Singapore; National Neuroscience Institute, Singapore; Duke-NUS Graduate Medical School, Singapore
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Müller T. Tolcapone addition improves Parkinson's disease associated nonmotor symptoms. Ther Adv Neurol Disord 2014; 7:77-82. [PMID: 24587824 DOI: 10.1177/1756285613512392] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Addition of catechol-O-methyltransferase inhibitors to a conventional levodopa/dopadecarboxylase inhibitor regimen improves motor symptoms in patients with Parkinson's disease. Optimizing dopamine substitution is also beneficial for nonmotor features. OBJECTIVES To investigate the efficacy of supplemental tolcapone intake on nonmotor symptoms. DESIGN/METHODS A total of 125 levodopa-treated patients additionally took tolcapone in this observational trial. Initially and following 4 weeks of tolcapone intake, the neurologist scored with Unified Parkinson's Disease Rating Scale parts I, II, IV, the nonmotor symptoms scale for Parkinson's disease and recorded the off time. The patients rated themselves with the EuroQuol, its visual analogue scale and the nonmotor screening questionnaire. Caregivers reported the daily duration of care giving. RESULTS All scores improved except for Unified Parkinson's Disease Rating Scale part IV and domains 4, 5 and 8 of the nonmotor symptoms scale for Parkinson's disease. CONCLUSION This trial demonstrates that tolcapone addition may improve nonmotor features.
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Affiliation(s)
- Thomas Müller
- Department of Neurology, St Joseph Hospital Berlin-Weissensee, Gartenstr. 1, 13088 Berlin, Germany
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Johnson SJ, Kaltenboeck A, Diener M, Birnbaum HG, Grubb E, Castelli-Haley J, Siderowf AD. Costs of Parkinson's disease in a privately insured population. PHARMACOECONOMICS 2013; 31:799-806. [PMID: 23907717 PMCID: PMC3757266 DOI: 10.1007/s40273-013-0075-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND This is the first analysis to estimate the costs of commercially insured patients with Parkinson's disease (PD) in the USA. Prior analyses of PD have not examined costs in patients aged under 65 years, a majority of whom are in the workforce. OBJECTIVE Our objective was to estimate direct and indirect costs associated with PD in patients under the age of 65 years who are newly diagnosed or have evidence of advanced PD. METHODS PD patients were selected from a commercially insured claims database (N > 12,000,000; 1999-2009); workloss data were available for a sub-sample of enrollees. Newly diagnosed patients with evidence of similar disorders were excluded. Patients with evidence of advanced PD disease, including ambulatory assistance device users (PDAAD) and institutionalized (PDINST) patients, as well as newly diagnosed PD patients, were analyzed. Each PD cohort was age-, gender- and region-matched to controls without PD. Direct (i.e. insurer payments to providers) and indirect (i.e. workloss) costs were reported in $US, year 2010 values, and were descriptively compared using Wilcoxon rank sum tests. RESULTS Patients had excess mean direct PD-related costs of $US4,072 (p < 0.001; N = 781) in the year after diagnosis. The PDAAD cohort (N = 214) had excess direct PD-related costs of $US26,467 (p < 0.001) and the PDINST cohort (N = 156) had excess direct PD-related costs of $US37,410 (p < 0.001) in the year after entering these states. Outpatient care was the most expensive cost source for newly diagnosed patients, while inpatient care was the most expensive for PDAAD and PDINST patients. Excess indirect costs were $US3,311 (p < 0.05; N = 173) in the year after initial diagnosis. CONCLUSIONS Direct costs for newly diagnosed PD patients exceeded costs for controls without PD, and increased with PD progression. Direct costs were approximately 6-7 times higher in patients with advanced PD than in matched controls. Indirect costs represented 45 % of total excess costs for newly diagnosed PD patients.
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Affiliation(s)
| | - Anna Kaltenboeck
- Analysis Group, Inc., 10 Rockefeller Plaza, 15th Floor, New York, NY 10020 USA
| | - Melissa Diener
- Analysis Group, Inc., 10 Rockefeller Plaza, 15th Floor, New York, NY 10020 USA
| | | | | | | | - Andrew D. Siderowf
- Department of Neurology, University of Pennsylvania, Philadelphia, PA USA
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Lökk J. Lack of information and access to advanced treatment for Parkinson's disease patients. J Multidiscip Healthc 2011; 4:433-9. [PMID: 22247618 PMCID: PMC3256003 DOI: 10.2147/jmdh.s27180] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) patients' own knowledge and experience and access to information, in relation to advanced treatment methods, are very limited. The aim of this study was to map out PD patients' perception about various advanced treatment methods, their availability and regional differences in medical care, and to investigate patients' experience of their medication and quality of life. METHODS A survey was sent to 4886 PD patients of the Swedish Parkinson's Disease Association covering demography, the patient's illness, current treatment, received information about advanced treatment alternatives, and health status. Advanced PD was considered as patients diagnosed >5 years ago, using PD medication >5 times/day, and experiencing motor complications >2 hours/day. RESULTS In total, 3327/4886 persons (68%) responded (57% men) of which 1300 (39%) were classified as having advanced PD. Mean age was 71 years with a median disease duration of 8 years. The treating physician was a neurologist (86%) but varied between counties (96% to 52%) and was most frequent in urban areas. Doctor appointments were 1.7 times/year with regional variation (2.1 to 1.1). Three out of four patients had heard of advanced treatment options and were interested, but were denied treatment. Only a small proportion of patients were informed of these by their physician. Nine percent were satisfied with their medication (including 4% of advanced patients). One third of patients experienced their general health as poor or very poor. CONCLUSION The majority of Swedish PD patients are treated by neurologists. Annual numbers of doctors' appointments were low in an international context and can partly be explained by the shortage of neurologists and other trained specialists. Doctors only provided a small proportion of patients with advanced therapy information, despite patients' interest. Hence, improvement is warranted regarding doctor appointments, information about various advanced treatment options, and their availability.
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Affiliation(s)
- J Lökk
- Department of Neurobiology, Caring Sciences and Society, The Karolinska Institute, Stockholm, Sweden
- Karolinska University Hospital Huddinge, Stockholm, Sweden
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Schapira AHV, Hillbom M. Publishing changes and information delivery in the clinical neurosciences. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.2011.03594.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Müller T, Muhlack S, Woitalla D. Pain perception, pain drug therapy and health status in patients with Parkinson's disease. Neuroepidemiology 2011; 37:183-7. [PMID: 22057029 DOI: 10.1159/000331911] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 08/04/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is traditionally characterized as a movement disorder; however, sensory perception problems including pain syndromes are also frequent. We performed a survey to analyze the relations between health status, pain perception and gender in 4,086 PD patients. Moreover, the participants should tick whether they took pain medications or not. SUBJECTS AND METHODS The questionnaire included the EQ-5D and visual analogue scales (VAS) on pain, which asked for mean (VAS A), most (VAS B), and minimal (VAS C) intensity of pain during an interval of 4 weeks prior to the completion of the survey. RESULTS PD patients were divided into three groups according to their EQ-5D total score (I: <8; II: 8-9; III: 10-15). An impairment of health status occurred in relation to the increase in pain syndromes in PD patients. There was a significant increase in VAS scores in relation to the EQ-5D group membership. Female patients reported more on pain and more frequently received a pain drug treatment than male patients. Significant associations were found between the VAS and the EQ-5D scores, and the correlation coefficients were higher in men than in women. CONCLUSIONS Pain is associated with the health status of PD patients and worsens it. More female than male PD patients have to deal with handling of pain and pain drug treatment.
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Affiliation(s)
- Thomas Müller
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
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McLaughlin D, Hasson F, Kernohan WG, Waldron M, McLaughlin M, Cochrane B, Chambers H. Living and coping with Parkinson's disease: perceptions of informal carers. Palliat Med 2011; 25:177-82. [PMID: 20952448 DOI: 10.1177/0269216310385604] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A review of the literature highlights the important role informal carers play in the provision of palliative care in the community. In order to explore the caring experience of relatives with Parkinson's Disease (PD), interviews were conducted with 26 informal family caregivers. Interviews were taped, transcribed and subjected to content analysis. All caregivers were spouses, the majority female (n = 17) and all were responsible for providing physical, social and emotional care in the home. Although they viewed care giving as their role and duty, the results highlight the widespread burden of providing care on the emotional and physical health of the caregivers. The financial implications for providing care were outlined, with many reporting difficulty in accessing benefits. From the point of diagnosis, which had a huge emotional impact on relatives and carers, carers did not feel health professionals integrated them within the caring journey. Since diagnosis, carers commented on the lack of continued and coordinated care plans for relatives, resulting in symptoms being mismanaged and care opportunities for relatives and carers missed. Stereotypes of the meaning and timing of palliative care were common with many viewing it as being synonymous with cancer and not applicable to a person with PD. As the well-being of the informal carer directly influences the care of the person with PD, support interventions are required to relieve their burden, maximize outcomes and ensure targeting of services.
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