Abstract
BackgroundThe introduction of deep brain stimulation (DBS) about 25 years ago provided one of the major breakthroughs in the treatment of Parkinson’s disease (PD). However, a high percentage of patients are reluctant to undergo DBS. Previous research revealed that the critical step on the patient’s path to DBS is the decision whether to undergo further diagnostic assessment for surgery at a specialized DBS-center. The aims of the current study were to evaluate how effective the combination of an outpatient DBS screening tool, STIMULUS, with specially developed educational material was to enhance patient education on DBS and to identify motivational aspects which influenced the patients’ willingness to undergo further assessment.MethodsIn total, 264 patients were identified as appropriate candidates for DBS by general neurologists using the electronic preselection tool STIMULUS. Patient-centered information material was designed and handed out to support education on DBS. Further, several clinical characteristics and details of the patient counseling were documented. Refusal or consent to show up at a DBS center was registered over the following 16 months.Results114 (43.2%) patients preselected as eligible for DBS (STIMULUS Score ≥ 6) agreed to show up at a specialized DBS center to undergo further diagnostic assessment. The patients’ ages, PD classification as an akinetic-rigid type and the talks’ topics side-effects of dopaminergic medication and the optimal time frame had a significant influence on the patients’ decisions.ConclusionsThe combination of preselection tools as STIMULUS with comprehensive information material is effective to increase DBS-acceptance rate in PD patients. Important topics of the information about DBS cover the optimal time frame for DBS surgery, the side-effects of dopaminergic medication as well as side-effects and complications of DBS surgery.
Highlights
The introduction of deep brain stimulation (DBS) about 25 years ago provided one of the major breakthroughs in the treatment of Parkinson’s disease (PD)
The selection process usually consists of two steps: A general neurologist preselects the patients and refers them to a specialized DBS center which takes the final decision for or against surgery based on comprehensive diagnostic assessment
The decision seems to be a struggle for general neurologists as only 48 to 55% of the patients initially referred to DBS centers were later assessed as appropriate candidates for surgery [5, 6]
Summary
The introduction of deep brain stimulation (DBS) about 25 years ago provided one of the major breakthroughs in the treatment of Parkinson’s disease (PD). Previous research revealed that the critical step on the patient’s path to DBS is the decision whether to undergo further diagnostic assessment for surgery at a specialized DBS-center. The selection process usually consists of two steps: A general neurologist preselects the patients and refers them to a specialized DBS center which takes the final decision for or against surgery based on comprehensive diagnostic assessment. In order to support the preselection, Moro and colleagues developed an online screening tool called STIMULUS [7]. This tool aids the general neurologists in the referral of patients with a range of registered demographic and clinical parameters.
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