Objective: To characterize the clinical and non-clinical features of ‘advanced’ PD patients considered to be eligible or ineligible for device-aided treatment (DAT) options by movement disorder specialists.

Background: OBSERVE-PD was a cross-sectional, observational study conducted at 128 movement disorder centers in 18 countries. A previous analysis reported that physicians judged 51% of the PD patients in participating movement disorder centers as ‘advanced’.

Methods: This is a post hoc analysis of the clinical and non-clinical characteristics of ‘advanced’ PD patients judged to be eligible or ineligible for DAT by the treating physician. Device-aided treatments included levodopa-carbidopa intestinal gel, apomorphine SC infusion, and neurosurgical treatments. Patient characteristics were analyzed using descriptive statistics.

Results: According to the physicians’ judgment, 66% (n=876) of ‘advanced’ PD patients were considered eligible for DAT options. DAT-eligible patients were on average (SD) 66.0 (9.2) years old with a mean (SD) PD duration of 12.2 (5.5) years. DAT-ineligible patients had a mean (SD) age and PD duration of 70.6 (9.1) and 8.6 (5.5) years, respectively. The primary reasons given for DAT-ineligibility were the patient needing more time to make a decision (43%) and patient refusal (28%). Notably, no patients were DAT-ineligible due to cost/reimbursement-related reasons.[table1] Of the 876 ‘advanced’ PD patients judged as DAT-eligible, 383 (44%) had ongoing DAT, 163 (19%) had decided to begin DAT during the study visit, and 330 (38%) had no DAT planned.[table2] At least 70% of DAT-eligible and ineligible patients experienced motor fluctuations and more than 50% had some form of caregiver support, with the most common type of caregiver being a partner or spouse.

Conclusions: This analysis of the global, multi-center OBSERVE-PD study shows a trend for ‘advanced’ PD patients judged  DAT-ineligible to be generally older individuals, with shorter disease duration, than DAT-eligible PD patients, however direct statistical comparisons were not performed. The primary reasons given for DAT-ineligibility were related to patient refusal/patient needing additional time to decide and notably, no patients were DAT-ineligible due to cost/reimbursement-related reasons. Additional analyses evaluating patient characteristics by individual DAT are planned.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/movement-disorder-specialists-determination-of-eligibility-for-device-aided-treatment-in-advanced-parkinsons-disease-results-from-the-observe-pd-study/