BACKGROUND: The issue of when to start treatment in Parkinson's disease (PD) remains controversial. Some favour treatment at diagnosis while others opt for a "wait and watch" policy. The effect of the latter policy on the self reported health status of people with PD is unknown. AIMS: To record self reported health status through longitudinal use of a validated PD specific questionnaire (PDQ-39) in untreated PD patients in multiple centres in the UK. To compare patients who were left untreated with those who were offered treatment during follow-up. METHODS: A multicentre, prospective, "real life" observational audit based study addressing patient reported outcomes in relation to self reported health status and other sociodemographic details. RESULTS: 198 untreated PD were assessed over a mean period of 18 months. During two follow-up assessments, the self reported health status scores in all eight domains of the PDQ-39 and the overall PDQ-39 summary index worsened significantly (p<0.01) in patients left untreated. In a comparative group in whom treatment was initiated at or soon after diagnosis, there was a trend towards improvement in self reported health status scores after treatment was started. CONCLUSIONS: This study addresses for the first time self reported health status, an indicator of health related quality of life, in untreated PD. The findings may strengthen the call for re-evaluation of the policy to delay treatment in newly diagnosed patients with PD.
BACKGROUND: The issue of when to start treatment in Parkinson's disease (PD) remains controversial. Some favour treatment at diagnosis while others opt for a "wait and watch" policy. The effect of the latter policy on the self reported health status of people with PD is unknown. AIMS: To record self reported health status through longitudinal use of a validated PD specific questionnaire (PDQ-39) in untreated PDpatients in multiple centres in the UK. To compare patients who were left untreated with those who were offered treatment during follow-up. METHODS: A multicentre, prospective, "real life" observational audit based study addressing patient reported outcomes in relation to self reported health status and other sociodemographic details. RESULTS: 198 untreated PD were assessed over a mean period of 18 months. During two follow-up assessments, the self reported health status scores in all eight domains of the PDQ-39 and the overall PDQ-39 summary index worsened significantly (p<0.01) in patients left untreated. In a comparative group in whom treatment was initiated at or soon after diagnosis, there was a trend towards improvement in self reported health status scores after treatment was started. CONCLUSIONS: This study addresses for the first time self reported health status, an indicator of health related quality of life, in untreated PD. The findings may strengthen the call for re-evaluation of the policy to delay treatment in newly diagnosed patients with PD.
Authors: Mickie Welsh; Michael P McDermott; Robert G Holloway; Sandy Plumb; Ronald Pfeiffer; Jean Hubble Journal: Mov Disord Date: 2003-06 Impact factor: 10.338
Authors: Robert G Holloway; Ira Shoulson; Stanley Fahn; Karl Kieburtz; Anthony Lang; Kenneth Marek; Michael McDermott; John Seibyl; William Weiner; Bruno Musch; Cornelia Kamp; Mickie Welsh; Aileen Shinaman; Rajesh Pahwa; Lynn Barclay; Jean Hubble; Peter LeWitt; Janis Miyasaki; Oksana Suchowersky; Mark Stacy; David S Russell; Blair Ford; John Hammerstad; David Riley; David Standaert; Frederick Wooten; Stewart Factor; Joseph Jankovic; Farah Atassi; Roger Kurlan; Michel Panisset; Ali Rajput; Robert Rodnitzky; Cliff Shults; Giselle Petsinger; Cheryl Waters; Ronald Pfeiffer; Kevin Biglan; Leona Borchert; Amy Montgomery; Laura Sutherland; Carolyn Weeks; Maryan DeAngelis; Elspeth Sime; Susan Wood; Carol Pantella; Mary Harrigan; Barbara Fussell; Sandra Dillon; Barbara Alexander-Brown; Pamela Rainey; Marsha Tennis; Elke Rost-Ruffner; Diane Brown; Sharon Evans; Debra Berry; Jean Hall; Theresa Shirley; Judith Dobson; Deborah Fontaine; Brenda Pfeiffer; Alicia Brocht; Susan Bennett; Susan Daigneault; Karen Hodgeman; Carolynn O'Connell; Tori Ross; Karen Richard; Arthur Watts Journal: Arch Neurol Date: 2004-07
Authors: Ralph Buchert; Carsten Buhmann; Ivayla Apostolova; Philipp T Meyer; Jürgen Gallinat Journal: Dtsch Arztebl Int Date: 2019-11-01 Impact factor: 5.594