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Fujioka S, Mishima T, Yamazaki T, Bebrysz M, Nomoto M, Yamaguchi J, Fujimura K, Migita H, Aballéa S, Tsuboi Y. Neurologists' preferences for device-aided therapy for advanced Parkinson's disease in Japan. Curr Med Res Opin 2023; 39:91-104. [PMID: 36217768 DOI: 10.1080/03007995.2022.2129800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study measures the relative preference for attributes of device-aided therapies (DATs) for advanced Parkinson's Disease (PD) from the perspective of Japanese neurologists. METHODS Attributes and levels were elicited based on literature and interviews with certified neurologists experienced with DATs. An online survey including a discrete choice experiment (DCE) was developed, pilot tested, and distributed through an online panel to neurologists treating advanced PD patients. Participants were asked to choose treatments among several choice sets of two hypothetical DATs described only by the attributes, or no DAT (continuing oral treatment). A conditional logit model using the Bayesian framework was developed to estimate the marginal utilities of attributes' levels, and the relative utility of treatments available to Japanese advanced PD patients or being developed in Japan was assessed. RESULTS The DCE survey completed by 308 neurologists showed that the attributes with the greatest influence on DAT selection were surgery requirement (relative importance of 28%), average increase in the duration of daily "on" time without dyskinesia which affects daily activities (15%), average change in cognitive function related to treatment introduction (15%), device management frequency (14%), average number of pills of oral PD medication after treatment introduction (13%), average influence of treatment on symptoms of depression (12%), and type of device (large/small) (3%). All attributes significantly influenced respondents' choices, except for external device type. Experience with DATs did not influence the directions of preferences. Out of treatment profiles representing DATs, continuous subcutaneous infusion of levodopa-carbidopa had a higher preference score than levodopa-carbidopa intestinal gel infusion and deep brain stimulation. CONCLUSIONS Our findings suggest that Japanese neurologists would prefer a DAT without surgery requirement. Other factors related to efficacy, safety, and administration mode have a significant, but a smaller influence on prescription choices.
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Affiliation(s)
- Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takayasu Mishima
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | | | | | | | | | | | | | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Ueno T, Hanabata N, Katagai A, Okudera R, Arai A, Tomiyama M. Phytobezoar Associated with Levodopa-carbidopa Intestinal Gel Infusion in Patients with Parkinson's Disease: A Case Report and Literature Review. Intern Med 2021; 60:3317-3320. [PMID: 33867393 PMCID: PMC8580754 DOI: 10.2169/internalmedicine.7210-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel (LCIG) is an established device-aided therapy for advanced Parkinson's disease (PD). Phytobezoar associated with LCIG is a rare device-related complication and presents with exacerbations of gastrointestinal and PD symptoms. We herein report the case of a phytobezoar that was formed at a knot on the pigtail-shaped J-tube and developed only in association with postprandial abdominal pain, similar to a feeling of a tube being pulled in without an exacerbation of PD symptoms. Such abdominal pain may be a warning sign of phytobezoar in LCIG-treated patients. Despite device-related complications, high-pressure alarms are not always present, and PD symptoms are not always exacerbated.
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Affiliation(s)
- Tatsuya Ueno
- Department of Neurology, Aomori Prefectural Central Hospital, Japan
| | - Norihiro Hanabata
- Department of Gastroenterology, Aomori Prefectural Central Hospital, Japan
| | - Atsuko Katagai
- Department of Neurology, Aomori Prefectural Central Hospital, Japan
| | - Rena Okudera
- Department of Neurology, Aomori Prefectural Central Hospital, Japan
- Division of Neurology, Department of Internal Medicine, National Defense Medical College, Japan
| | - Akira Arai
- Department of Neurology, Aomori Prefectural Central Hospital, Japan
| | - Masahiko Tomiyama
- Department of Neurology, Hirosaki University Graduate School of Medicine, Japan
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Bhidayasiri R, Phokaewvarangkul O, Sakdisornchai K, Boonpang K, Chaudhuri KR, Parsons J, Lolekha P, Chairangsaris P, Srivanitchapoom P, Benedierks S, Panyakaew P, Boonmongkol T, Thongchuam Y, Kantachadvanich N, Phumphid S, Evans AH, Viriyavejakul A, Pisarnpong A, van Laar T, Jagota P. Establishing apomorphine treatment in Thailand: understanding the challenges and opportunities of Parkinson's disease management in developing countries. Expert Rev Neurother 2020; 20:523-537. [PMID: 32421371 DOI: 10.1080/14737175.2020.1770598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The increasing global burden of Parkinson's disease (PD) poses a particular challenge for developing countries, such as Thailand, when delivering care to a geographically diverse populace with limited resources, often compounded by a lack of expertise in the use of certain PD medications, such as device-aided therapies (DAT). AREAS COVERED A panel of local, regional, and international PD experts convened to review the unmet needs of PD in Thailand and share insights into effective delivery of DAT, focusing on experience with apomorphine infusion. Despite its proven efficacy and safety, implementation of apomorphine infusion as a new option was not straightforward. This has prompted a range of health-care professional and patient-focused initiatives, led by the Chulalongkorn Center of Excellence for Parkinson's Disease and Related Disorders in Bangkok, to help establish a more coordinated approach to PD management throughout the country and ensure patients have access to suitable treatments. EXPERT OPINION Overcoming the challenges of education, proficiency, resource capacity and standard of care for PD patients in developing countries requires a coordinated effort both nationally and beyond. The best practices identified in Thailand following the introduction of apomorphine infusion might be helpful for other countries when implementing similar programs.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Karn Sakdisornchai
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Kamolwan Boonpang
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - K Ray Chaudhuri
- The Maurice Wohl Clinical Neuroscience Institute, King's College London and National Parkinson Foundation Centre of Excellence, King's College Hospital , London, UK
| | - Jan Parsons
- The Walton Centre for Neurology and Neurosurgery , Liverpool, UK
| | - Praween Lolekha
- Division of Neurology, Department of Medicine, Thammasat University Hospital , Pathumthani, Thailand
| | - Parnsiri Chairangsaris
- Division of Neurology, Department of Medicine, Phra Mongkutklao Hospital , Bangkok, Thailand
| | - Prachaya Srivanitchapoom
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University , Bangkok, Thailand
| | | | - Pattamon Panyakaew
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Thanatat Boonmongkol
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Yuwadee Thongchuam
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Nitinan Kantachadvanich
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Saisamorn Phumphid
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
| | - Andrew H Evans
- Department of Neurology, Royal Melbourne Hospital , Melbourne, Australia
| | | | - Apichart Pisarnpong
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University , Bangkok, Thailand
| | - Teus van Laar
- Department of Neurology, University of Groningen , Groningen, The Netherlands
| | - Priya Jagota
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society , Bangkok, Thailand
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Sahlström T, Eklund M, Timpka J, Henriksen T, Nyholm D, Odin P. Workforce participation and activities in Parkinson's disease patients receiving device-aided therapy. Acta Neurol Scand 2018; 138:78-84. [PMID: 29569237 DOI: 10.1111/ane.12929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Many countries have an aging population, and it is thus likely that Parkinson's disease (PD) will become an increasing health problem. It is important to ensure this group can use their resources in the best way possible, including remaining in the work market. This study aimed to investigate workforce participation and daily activities among patients with PD receiving device-aided therapy to provide new knowledge that may be used to inform decisions about these therapy options. MATERIALS AND METHODS This was a retrospective, descriptive quantitative pilot study, including 67 patients with PD from 3 centers in Sweden and Denmark. Included patients were younger than 67 years at the time of introduction of device-aided therapy. Eligible patients were identified by the Swedish national Parkinson patient registry or by the treating neurologist. Quantitative interviews were made by telephone. RESULTS A majority of the patients could perform the same, or more, amount of activities approximately 5 years after the introduction of device-aided therapy. A small number of patients receiving deep brain stimulation (DBS) and levodopa-carbidopa intestinal gel (LCIG) were able to increase their work capacity within 1 year of initiating device-aided therapy and a remarkably high share could still work at the end-point of this study, approximately 15 years since the diagnosis of PD. CONCLUSIONS Device-aided therapy may sustain or increase daily activities and workforce participation in patients with PD who have not yet reached retirement age. There is need for prospective studies, both quantitative and qualitative, to confirm these results.
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Affiliation(s)
- T. Sahlström
- Department of Clinical Sciences, Neurology; Faculty of Medicine; Lund University; Lund Sweden
| | - M. Eklund
- Department of Health Sciences; Mental Health, Activity and Participation (MAP); Lund University; Lund Sweden
| | - J. Timpka
- Department of Clinical Sciences, Neurology; Faculty of Medicine; Lund University; Lund Sweden
- Department of Neurology; Skåne University Hospital; Lund Sweden
| | - T. Henriksen
- Movement Disorder Clinic; University Hospital of Bispebjerg; Copenhagen Denmark
| | - D. Nyholm
- Department of Neuroscience; Uppsala University; Uppsala Sweden
| | - P. Odin
- Department of Clinical Sciences, Neurology; Faculty of Medicine; Lund University; Lund Sweden
- Department of Neurology; Skåne University Hospital; Lund Sweden
- Department of Neurology; Central Hospital; Bremerhaven Germany
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