Impact of device-aided therapies on quality of life in patients with Parkinson's disease. A comparative multicenter observational study

Abstract

Device aided-therapies (DATs) improve health-related quality of life (HRQoL) in people with Parkinson's disease (PwP). However, no studies comparing all DATs have been conducted to date. Our aim was to compare the effect of different DATs on HRQoL and other disease-related variables in PwP. Data from baseline (V1) and the 6-month follow-up visit (V3.6 M) were collected from a descriptive, observational, prospective, multicenter, clinical registry conducted in Spain entitled DATs-PD GETM Spanish Registry. The primary endpoint was the change from V1 to V3.6 M in the 39-item Parkinson's Disease Questionnaire (PDQ-39) total score. Relative change (RC) and Cohen's d (d) effect were applied. The effect over many other variables was also analyzed. HRQoL improved significantly in the entire cohort (N = 137) with a moderate decrease of 13.4% in the PDQ-39 total score (from 58.9 ± 22.9 at V1 to 51.0 ± 26.8 at V3.6 M; d = 0.51; p < 0.0001). No differences in the change of the PDQ-39 total score were detected between both subcutaneous therapies (i.e., foslevodopa/foscarbidopa [fLD/fCD] and continuous subcutaneous apomorphine infusion [CSAI]; p = 0.666) and between subcutaneous and enteral therapies (p = 0.721). Although a greater improvement in HRQoL was observed in PwP treated with deep brain stimulation (DBS) (N = 30; RC = -26.3%; d = 0.83; p = 0.002) compared to those who received a pump system (N = 107; RC = -10.2%; d = 0.41; p = 0.003) (p = 0.009), the effect was not significant after adjustment for age, sex, and disease duration (p = 0.161). Off time, dyskinesia, motor symptoms, and non-motor symptoms improved significantly in the entire cohort. HRQoL improved in PwP after being treated with a DAT.

Keywords: Deep Brain stimulation; Device-aided therapies; Infusion; Parkinson’s disease; Quality of life; Subcutaneous.