Abstract

Background:

Non-motor symptoms (NMS) reduce quality of life in Parkinson’s disease (PD) patients, who experience three times more NMS than individuals without PD. While there are international and national NMS treatment guidelines, their implication in clinical practice remains unclear.

Objective:

This study aimed to investigate the adherence to pharmacological NMS treatment guidelines in patients with mild to moderately severe PD.

Methods:

220 PD patients with ≥1 NMS based on the Non-Motor Symptom Questionnaire and a Hoehn and Yahr stage ≤4 were randomly selected from the Swedish Parkinson registry and screened for inclusion. NMS were evaluated using the International Parkinson and Movement Disorder Society–Non-Motor Rating Scale (MDS-NMS), Parkinson’s Disease Sleep Scale 2, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale. Treatment was compared with Swedish national guidelines and international guidelines from the MDS Evidence-Based Medicine Committee.

Results:

Among 165 included patients, the median number of NMS was 14, and in median 7 symptoms were estimated to require treatment. The most common NMS requiring treatment were pain (69%) and urinary problems (56%). Treatment of depression and constipation demonstrated the highest adherence to guidelines (79% and 77%), while dysphagia and excessive daytime sleepiness exhibited the lowest adherence (0% and 4%). On average, only 32% of NMS were treated in accordance with guidelines.

Conclusions:

Adherence to pharmacological guidelines for NMS in patients with mild to severe PD was low. This study highlights the need for improved evaluation and treatment of NMS to enhance symptom management and quality of life among PD patients.

中文翻译：

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非运动症状管理：深入了解帕金森病患者遵守治疗指南的情况

摘要

背景：

非运动症状 (NMS) 会降低帕金森病 (PD) 患者的生活质量，他们所经历的 NMS 是没有 PD 患者的三倍。尽管有国际和国家 NMS 治疗指南，但其在临床实践中的意义仍不清楚。

客观的：

本研究旨在调查轻度至中度重度 PD 患者对药物 NMS 治疗指南的依从性。

方法：

从瑞典帕金森登记处随机选择 220 名根据非运动症状问卷 NMS ≥1 且 Hoehn 和 Yahr 分期≤4 的 PD 患者并进行筛选。NMS 使用国际帕金森和运动障碍协会非运动评定量表 (MDS-NMS)、帕金森病睡眠量表 2、Epworth 嗜睡量表以及医院焦虑和抑郁量表进行评估。将治疗与瑞典国家指南和 MDS 循证医学委员会的国际指南进行了比较。

结果：

在纳入的 165 名患者中，NMS 的中位数为 14，其中估计有 7 种症状需要治疗。最常见的需要治疗的 NMS 是疼痛（69%）和泌尿问题（56%）。抑郁症和便秘的治疗对指南的遵守率最高（79% 和 77%），而吞咽困难和白天过度嗜睡的遵守率最低（0% 和 4%）。平均而言，只有 32% 的 NMS 得到了按照指南的治疗。

结论：

轻度至重度 PD 患者对 NMS 药理学指南的遵守率较低。这项研究强调需要改进 NMS 的评估和治疗，以加强 PD 患者的症状管理和生活质量。