Article (Scientific journals)
Treatments for progressing Parkinson's disease: a clinical case scenario study.
MAERTENS DE NOORDHOUT, Alain; Santens, Patrick; Gerard, Jean-Marie et al.
2009In Acta Neurologica Belgica, 109 (3), p. 189-99
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Keywords :
Aged; Antiparkinson Agents/therapeutic use; Consensus; Decision Making; Disease Progression; Evidence-Based Medicine; Humans; Middle Aged; Neurology/standards; Parkinson Disease/drug therapy; Practice Guidelines as Topic
Abstract :
[en] OBJECTIVE: A 'case scenario' study on clinical decisions in progressing Parkinson's disease (PD) was developed to complement scientific evidence with the collective judgment of a panel of experts. METHODS: The opinions of 9 experts in movement disorders on the appropriateness of 9 common pharmacological treatments for 33 hypothetical patient profiles were compared to those of 14 general neurologists. Before rating the case scenarios, all participants received a document integrating European and US guidelines for the treatment of patients with advanced PD. Case scenarios showing disagreement or with inconsistencies in appropriateness ratings were discussed at a feedback meeting. A tool for interactive discussion on the clinical case scenarios included was developed based on the outcome of the study. RESULTS: Current guidelines are often insufficient to adequately guide the management of patients with progressing PD. The case scenario study did not reveal major differences in opinions between experts in movement disorders and general neurologists about the appropriateness of certain drug choices for specific case scenarios. However in about 1 out of 5 treatment decisions where experts stated appropriateness or inappropriateness, the general neurologists panel had no or dispersed opinions. CONCLUSIONS: This study reveals more uncertainty about treatment of advanced PD in general neurologists compared with experts in movement disorders and underlines the need for additional support for guiding treatment decisions in clinical practice.
Disciplines :
Neurology
Author, co-author :
MAERTENS DE NOORDHOUT, Alain  ;  Centre Hospitalier Universitaire de Liège - CHU > Neurologie CHR
Santens, Patrick
Gerard, Jean-Marie
Gonce, Michel ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Jeanjean, Anne
Flamez, Anja
Pickut, Barbara
Van Zandijcke, Michel
Pahwa, Rajesh
Language :
English
Title :
Treatments for progressing Parkinson's disease: a clinical case scenario study.
Publication date :
September 2009
Journal title :
Acta Neurologica Belgica
ISSN :
0300-9009
eISSN :
2240-2993
Publisher :
Acta Medica Belgica, Bruxelles, Belgium
Volume :
109
Issue :
3
Pages :
189-99
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 27 December 2011

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