Klepitskaya O, Serbin M, Sutphin J, Leach C, Mansfield C, Yonan C, Sheehan M, Donnelly A. Development of a patient survey on preferences for adjunctive parkinson's disease medications: results from pretest interviews. Poster presented at the AMCP Nexus 2021; October 18, 2021. [abstract] J Manag Care Pharm. 2021 Oct; 27(10-a):S8.

BACKGROUND: “OFF” episodes between levodopa/carbidopa (LD/CD) doses can be burdensome for patients with Parkinson’s Disease (PD). New oral adjunctive treatments, such as once-daily opicapone, have been shown to reduce the duration of “OFF” time in clinical trials. Patients’ perspectives on adjunctive treatments should be considered, but this type of patient-centered research is limited.

OBJECTIVE: Conduct pretest interviews to refine/prepare a survey focusing on patient preferences for various attributes of adjunctive PD medications.

METHODS: The survey was developed based on published data and prescribing information for approved PD treatments, along with input from clinical experts and patient advisors. Semi-structured pretest interviews were conducted with participants who were recruited through a large Parkinson’s advocacy group, as follows: US resident, aged 30-83 years, self-reported physician diagnosis of PD, current treatment with LD/CD, and ≥1 “OFF” episode in the past week. Pretest interviews focused on preference questions offering hypothetical medications defined by 6 attributes with varying levels (i.e., amount of additional “ON” time, potential risks for dyskinesia and other side effects) and the option of no new treatment, as well as patient’s current medication and “OFF” episode experience. Results from these interviews will be used to refine a final survey.

RESULTS: Of the 15 pretest participants, 9 (60%) were male and mean age (±SD) was 62 (±8) years. Participants reported having 1-5 “OFF” episodes/week, with a majority taking ≥1 adjunctive medication in addition to their LD/CD regimen (3-6 doses/day) and other current medications (5-30 pills/day for PD and other conditions). When presented with two hypothetical adjunctive medications, preferences varied by patient. For example, some preferred lower side effect risks; others preferred a once-daily medication. However, 93% (13/14) chose adding a medication that would offer ~1.5-2 hours of additional “ON” time with various side effects (vs no medication), despite complicated preexisting medication regimens.

CONCLUSIONS: Findings from these pretest interviews are being used to develop a final survey. This survey will assess patient preferences for attributes of adjunctive PD medications when balancing issues such as efficacy, potential side effects, and preexisting pill burden. This research highlights the importance of patient preferences when choosing PD medications, which can be used to inform patients about treatment options and improve outcomes.

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