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Nervenheilkunde 2015; 34(03): 167-171
DOI: 10.1055/s-0038-1627573
Parkinson
Schattauer GmbH

Qualitätssurvey mit dem Patientenfragebogen der neuen MDS-UPDRS bei stationären Parkinson-Patienten

Quality survey using the patient reported activity of living questionnaire of the new MDS-UPDRS
U. M. Fietzek
1   Abt. Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik, Schön Klinik München Schwabing
,
M. Paulig
1   Abt. Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik, Schön Klinik München Schwabing
,
M. Messner
1   Abt. Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik, Schön Klinik München Schwabing
,
A. Ceballos-Baumann
1   Abt. Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik, Schön Klinik München Schwabing
› Author Affiliations
Further Information

Publication History

eingegangen am: 26 January 2015

angenommen am: 26 January 2015

Publication Date:
22 January 2018 (online)

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Zusammenfassung

Die Erfassung der Qualität medizinischer Dienstleistungen ist bei chronischen und komplexen neurologischen Erkrankungen wie der Parkinsonkrankheit eine Herausforderung. Wir führten im Jahr 2012 ein Qualitätssurvey mit dem Patientenfragebogen der neuen MDS-UPDRS-Skala (Movement Disorder Society Unified Parkinson Disease Rating Scale) durch. Der Patiententeil der Skala evaluiert motorische und nicht motorische Symptome mit 20 Items, die jeweils Werte von 0 bis 4 annehmen können. Von 1 097 stationären Patienten mit Parkinson-Syndrom im Jahr 2012 konnten korrespondierende Vorher-Nachher-Daten (bei Aufnahme und postalisch nach Entlassung) eines Samples mit 220 Patienten (20%) mit idiopathischer Parkinsonkrankheit erhoben werden. Der Mittelwert des Summenscore verbesserte sich in dieser Population um 3,2 Skalenpunkte (p < 0,001) zum Zeitpunkt zwei Wochen nach Entlassung. Der MDS-UPDRS erweist sich so als praktikables, objektives und valides Instrument, um die Qualität der stationären Behandlung von Parkinsonpatienten zu erfassen.

Summary

The assessment of medical care is challenging, especially when it comes to chronic and complex neurological disorders such as Parkinson’s disease. In the year 2012, we performed a quality survey using the patient reported activity of living questionnaire of the new MDS-UPDRS (Movement Disorder Society Unified Parkinson’s Disease Rating Scale). This scale evaluates motor and nonmotor symptoms using 20 items that can be rated by the patient from 0 (normal) to 4 (severe). From 1 097 patients with parkinsonian syndromes in the year 2012 we received before-after data sets from 220 (20%) patients with Parkinson’s disease. The mean sum score improved by 3.2 points ( p < 0.001) two weeks after discharge from the hospital. Thus, the MDS-UPDRS is demonstrated to be a practicable, objective and valid instrument to assess the quality of in-house treatment of Parkinson patients.

Schlüsselwörter

Parkinson-Syndrom - UPDRS - Qualitätsmanagement - stationäre Behandlung

Keywords

Parkinson’s disease - UPDRS - quality management - inpatient treatment
 

  • Literatur

  • 1 Bennett DA, Beckett LA, Murray AM, Shannon KM, Goetz CG, Pilgrim DM. et al. Prevalence of parkinsonian signs and associated mortality in a community population of older people. N Engl J Med 1996; 334 (02) 71-6.
    CrossrefPubMedSearch in Google Scholar
  • 2 Braak H, Del Tredici K, Bratzke H, Hamm-Clement J, Sandmann-Keil D, Rüb U. Staging of the intracerebral inclusion body pathology associated with idiopathic Parkinson’s disease (preclinical and clinical stages). J Neurol 2002; 249 (Suppl. 03) III/ 1-5.
    PubMedSearch in Google Scholar
  • 3 Lang AE, Lees A. Management of Parkinson’s disease: An evidence-based review. Mov Disord 2002; 17 (S4): i-i.
    CrossrefSearch in Google Scholar
  • 4 Langston JW. The Parkinson’s complex: parkinsonism is just the tip of the iceberg. Ann Neurol 2006; 59 (04) 591-6.
    CrossrefPubMedSearch in Google Scholar
  • 5 Chaudhuri KR, Healy DG, Schapira AH. Nonmotor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol 2006; 05 (03) 235-45.
    CrossrefPubMedSearch in Google Scholar
  • 6 Cilia R, Akpalu A, Sarfo FS, Cham M, Amboni M, Cereda E. et al. The modern pre-levodopa era of Parkinson’s disease: insights into motor complications from sub-Saharan Africa. Brain 2014; 137 (10) 2731-42.
    CrossrefPubMedSearch in Google Scholar
  • 7 Petzinger GM, Fisher BE, McEwen S, Beeler JA, Walsh JP, Jakowec MW. Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s disease. Lancet Neurol 2013; 12 (07) 716-26.
    CrossrefPubMedSearch in Google Scholar
  • 8 Ebersbach G. Parkinson disease: Exercise matters in patients with PD-another piece of evidence. Nat Rev Neurol 2015; 11 (01) 9-10.
    CrossrefPubMedSearch in Google Scholar
  • 9 Schuepbach WMM, Rau J, Knudsen K, Volkmann J, Krack P, Timmermann L. et al. Neurostimulation for Parkinson’s Disease with Early Motor Complications. N Engl J Med 2013; 368 (07) 610-22.
    CrossrefPubMedSearch in Google Scholar
  • 10 Olanow CW, Kieburtz K, Odin P, Espay AJ, Standaert DG, Fernandez HH. et al. Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel for patients with advanced Parkinson’s disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurol 2014; 13 (02) 141-9.
    CrossrefPubMedSearch in Google Scholar
  • 11 Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schäfer H, Bötzel K. et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 2006; 355 (09) 896-908.
    CrossrefPubMedSearch in Google Scholar
  • 12 García PJRuiz, Sesar AIgnacio, Ares BPensado, Castro AGarcía, Alonso FFrech, Alvarez MLópez. et al. Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson’s disease with motor fluctuations: a multicenter study. Mov Disord 2008; 23 (08) 1130-6.
    CrossrefPubMedSearch in Google Scholar
  • 13 Dodel R, Jönsson B, Reese JP, Winter Y, Martinez-Martin P, Holloway R. et al. Measurement of costs and scales for outcome evaluation in health economic studies of Parkinson’s disease. Mov Disord 2014; 29 (02) 169-76.
    CrossrefPubMedSearch in Google Scholar
  • 14 Dams J, Klotsche J, Bornschein B, Reese JP, Balzer-Geldsetzer M, Winter Y. et al. Mapping the EQ-5D index by UPDRS and PDQ-8 in patients with Parkinson’s disease. Health Qual Life Outcomes 2013; 11: 35.
    CrossrefPubMedSearch in Google Scholar
  • 15 Jenkinson C, Fitzpatrick R, Peto V. Health-related quality-of-life measurement in patients with Parkinson’s disease. PharmacoEconomics 1999; 15 (02) 157-65.
    CrossrefPubMedSearch in Google Scholar
  • 16 Peto V, Jenkinson C, Fitzpatrick R. PDQ-39: a review of the development, validation and application of a Parkinson’s disease quality of life questionnaire and its associated measures. J Neurol 1998; 245 Suppl 1: S10-4.
    PubMedSearch in Google Scholar
  • 17 Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 2008; 23 (15) 2129-70.
    CrossrefPubMedSearch in Google Scholar
  • 18 Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Mov Disord 2007; 22 (01) 41-7.
    CrossrefPubMedSearch in Google Scholar
  • 19 Schrag A, Spottke A, Quinn NP, Dodel R. Comparative responsiveness of Parkinson’s disease scales to change over time. Mov Disord 2009; 24 (06) 813-8.
    CrossrefPubMedSearch in Google Scholar
  • 20 Rascol O, Brooks DJ, Korczyn AD, De Deyn PP, Clarke CE, Lang AE. A five-year study of the incidence of dyskinesia in patients with early Parkinson’s disease who were treated with ropinirole or levodopa. 056 Study Group. N Engl J Med 2000; 342 (20) 1484-91.
    CrossrefPubMedSearch in Google Scholar