Patient perspectives on Parkinson’s disease therapy in Japan and the United States: results of two patient surveys

Nobutaka Hattori,¹ Kenichi Fujimoto,² Tomoyoshi Kondo,³ Miho Murata,⁴ Mark Stacy<sup>5

1</sup>Department of Neurology, Juntendo University School of Medicine, Tokyo; ²Department of Neurology, Jichi Medical University, Tochigi; ³Department of Neurology, Wakayama Medical University, Wakayama; ⁴Department of Neurology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan; ⁵Division of Neurology, Duke University, Durham, NC, USA

Background: Despite evidence suggesting that patient attitudes towards therapy may influence treatment outcomes, the impact of these factors on treatment for Parkinson’s disease is poorly understood. These two surveys, based in Japan and the US, investigated the attitudes of patients towards antiparkinsonian medications, the complications of these therapies, and how these differ across geographies.
Methods: The US PRELUDE survey collected data from May 13 to May 20, 2003, from 300 interviews with patients with Parkinson’s disease from the National Parkinson Foundation. The Japanese survey was carried out from June to December 2008 in a stepwise manner using questionnaires (n = 3548) followed by interviews with those who had consented to participate in the questionnaire (n = 407). Both surveys assessed the attitudes of patients towards therapies for Parkinson’s disease and associated complications.
Results: Dyskinesia was not a major challenge of therapy for Parkinson’s disease, and wearing-off caused greater concern in the US, while hallucinations had a greater emphasis in Japan. Patients who had previously experienced dyskinesia were less concerned about this side effect than those who had not. Although pill burden was thought to be a concern in the US, Japanese patients did not indicate that pill burden would limit their drug intake. There were also discrepancies between the perspectives and concerns of patients and those of their treating physicians.
Conclusion: Recognizing patient perspectives regarding therapies for Parkinson’s disease and associated complications, as well as certain cultural influences, is important in the management of parkinsonian symptoms. Acknowledging these concerns may improve the standard of care in patients with Parkinson’s disease. In addition, improved patient education and effective patient–physician communication in both countries may improve compliance and treatment outcomes in patients with the disease.

Keywords: Parkinson’s disease, patient concerns, dyskinesia, wearing-off, hallucinations