Objective: To explore if any inconsistency exists in the perception of the presence of wearing-off (WO) symptoms between patients and physicians in Parkinson’s disease (PD).

Background: Recognizing the complications in progressive diseases such as PD is very challenging for physicians. Several questionnaires were developed to identify the motor complications relating to levodopa treatment (e.g. WOQ-9), however these questionnaires are not routinely used in clinical practice. Detection of disease progression has relied on the physician’s assessment, therefore accurate information sharing between patients and physicians is critical for appropriate assessment.

Method: Survey in patients with PD and their physicians were conducted in Japan. A web screening was conducted following with the questionnaires for both patients and physicians. The completed questionnaires from the patient and the physician were collected separately by mail. WOQ-9 was used to assess the presence of WO objectively (the presence of WO: WOQ-9 >=2). McNemar tests were used for comparisons between the patient’s self-awareness/physician’s assessment, patient’s self-awareness/WOQ-9, and physician’s assessment/ WOQ-9 separately.

Results: A total of 237 patients with PD and their physicians participated in this survey. WO was observed in 35.32% of PD patients by patient’s self-awareness and 45.96% of PD patients by physician’s assessment. The discordance between patient’s self-awareness/physician’s assessment were observed in 49 (20.85%) cases (p<0.0004), and 37 (15.74%) patients under-recognized their own WO compared with their physicians. In addition, WOQ-9 detected WO in 67.23%. The discordance between patient’s/WOQ-9 and physician’s/WOQ-9 were found in 99 (42.13%) cases (p<.0001) and 92 (39.15%) cases (p<.0001) respectively. Table. 1 Comparison of the number of patients self-assessed or diagnosed with wearing-off by patient’s self-awareness, physician’s assessment, or WOQ-9. [table1]

Conclusion: This study showed the low-awareness of WO in patients compare to the physician’s assessment. Further analysis is needed to assess the impact of this inconsistency between patient’s self-awareness, physician’s assessment, and the objective scales on patient’s quality of life.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/difference-in-perception-of-the-wearing-off-between-patients-and-physicians-in-parkinsons-disease/