Abstract
Objective This study aimed to gain an understanding of patient and physician satisfaction with overall treatment and routine consultations for Parkinson's disease in clinical practice. Methods This observational, cross-sectional, web-based survey was conducted in Japan from February to March 2019. Eligible patients with Parkinson's disease (N = 186) and physicians who treat patients with Parkinson's disease (N = 331) were asked to evaluate their satisfaction with treatment, consultation, symptom control, and use of a symptom diary. Results Patients had a mean age of 62.7 years, 54.8% were male, and most (75.8%) had Hoehn and Yahr stage ≥3 symptoms. Physicians were mostly male (93.1%) and had treated 52 patients with Parkinson's disease in the last 6 months, and 34.1% were certified neurologists. There were significant gaps between patient and physician satisfaction with treatment and consultations. Patient and physician satisfaction with overall treatment was significantly lower for patients with Hoehn and Yahr stage ≥3 symptoms than stage 1-2 symptoms (patients: 53.9% vs. 71.1%; physicians: 43.2% vs. 69.7%, respectively). The proportion of patients who were satisfied with symptom control was lower than that of physicians (26.4% vs. 51.5%). Influencing factors for patient satisfaction with treatment were nonmotor symptoms (e.g., insomnia and depression). Satisfaction tended to be higher for patients and physicians when symptom diaries were used. Conclusion Significant gaps in perceptions of treatment and consultation exist between patients and physicians in Parkinson's disease. Physicians should participate in shared decision making with their patients and consider strategies for management of nonmotor symptoms and nonpharmacological therapies and encourage the use of symptom diaries.
Highlights
Introduction e global burden ofParkinson’s disease, which is one of the fastest-growing neurological diseases worldwide, increased more than two-fold from 1990 to 2016, in part because of aging populations and increased life expectancy [1]
Patient and physician satisfaction with overall treatment was significantly lower for patients with Hoehn and Yahr stage ≥3 symptoms than stage 1-2 symptoms. e proportion of patients who were satisfied with symptom control was lower than that of physicians (26.4% vs. 51.5%)
54.8% were male with a mean age of 62.7 years. e mean age at diagnosis of Parkinson’s disease was 56.2 years, the mean duration of disease since diagnosis was 6.5 years, and 75.8% of patients had moderate-to-severe symptoms (Table 1)
Summary
Introduction e global burden ofParkinson’s disease, which is one of the fastest-growing neurological diseases worldwide, increased more than two-fold from 1990 to 2016, in part because of aging populations and increased life expectancy [1]. In Japan, which has a rapidly aging population, the number of patients with Parkinson’s disease increased from 75,000 in 1987 to 162,000 in 2017 [2]. No drugs with neuroprotective effects have been developed for Parkinson’s disease, and patients require long-term multidisciplinary care as both motor and nonmotor symptoms emerge and gradually worsen over time [3]. Because symptomatology is heterogenous, management of patients with Parkinson’s disease requires tailored therapies that focus on the most common symptoms experienced by individual patients [3, 4]. Patient-physician communication is a significant contributor to patient satisfaction and improvements in quality of life in Parkinson’s disease [8, 9], very few studies Communication between patients and their physicians is critically important for ensuring that patients receive the most appropriate information and have access to the most appropriate care throughout their disease journey [5,6,7].
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