Medikamentöse Therapie des Parkinson-Syndroms: Selbsteinschätzung der Parkinson-Patienten in einer Querschnittserhebung

Zusammenfassung

In Deutschland fehlen aktuelle Daten zur Behandlungssituation von Parkinson-Patienten. Entsprechend wurde deshalb eine Querschnittserhebung an 4 485 Patienten sowie den behandelnden niedergelassenen Neurologen durchgeführt. Die Patienten wurden zum Krankheitsverlauf, der Behandlungshistorie und aktuellen Behandlung sowie ihrer Therapiezufriedenheit befragt.

Der Zeitraum zwischen Diagnosestellung und der erstmaligen Verordnung von Parkinson-Medikamenten war bei 68,9% der Patienten unter 3 Monate, bei 15,6% zwischen 3 und 6 Monaten, bei 7,1% bis zu einem Jahr, bei 3,3% bis 2 Jahre und mehr als 2 Jahre bei 3,1%. Von den Patienten schätzten sich 9,7% im Anfangsstadium der Erkrankung, 44,3% im mittleren Stadium und 41,3% im fortgeschrittenen Stadium ein. Den Behandlungserfolg ihrer Parkinson-Therapie beurteilten 4,9% als sehr gut, 22,6% als gut, 43,4% als zufriedenstellend, 17,6% als nicht zufriedenstellend, 5,4% als unbefriedigend und 2,1% als schlecht (4,1% keine Angabe). Den Behandlungserfolg ihrer Therapie machten 51,3% der Patienten an den motorischen Symptomen, 6,5% an nicht-motorischen Symptomen, 23,4% an der Wahrnehmungsfähigkeit, 57,0% an der Lebensqualität und 21,5% an der Beeinträchtigung durch die Medikation fest. In Hinblick auf die aktuelle Therapie fühlten sich 41,8% durch die Einnahmehäufigkeit gestört, 3,2% durch die Art der Anwendung, 12,3% durch die Mehrfachmedikation, 27,7% durch eine unzureichende Wirksamkeit und 41,29% durch Nebenwirkungen (Mehrfachnennungen möglich). Insgesamt bewerteten nur 27,5% der Patienten ihre aktuelle Parkinson-Therapie als sehr gut oder gut, die meisten jedoch diese nur als zufriedenstellend oder sogar als nicht zufriedenstellend. Diese Aussage stand im deutlichen Kontrast zur wesentlich positiveren globalen Einschätzung der behandelnden Ärzte.

Zusammenfassend berichten die Patienten Defizite in der medikamentösen Versorgung. Es besteht ein deutlicher Handlungsbedarf in Bezug auf die Informationsweitergabe an Patienten (u. a. Erklärung von Nebenwirkungen bzw. Differenzierung von Symptomen der Parkinson-Erkrankung) und für eine Umstellung der Medikationsschemata auf andere Präparate oder Kombinationen.

Abstract

In Germany, data on the current treatment situation of patients with Parkinson‘s disease are lacking. Therefore, a cross-sectional survey of 4485 patients and neurologists treating them was performed. Patients were questioned on disease progression, treatment history, current treatment, and satisfaction with treatment. The time between diagnosis and initial prescription of drugs to treat the disease varied between 3 months and 2 years. Patient assessment of their disease stage was also varied considerably. Improvement was reported in motor symptoms (51.3%), in non-motor symptoms (6.5%), in perception (23.4%), quality-of-life (57.0%) and reduction in medication-associated impairment (21.5%). With regard to the current therapy, 41.8% felt disturbed by frequency of administration, 3.2% by the type of application, 12.3% by multiple medication, 27.7% due to insufficient efficacy and 41.29% by side effects (multiple answers possible). Overall, only 27.5% of patients rated their current Parkinson’s disease therapy as good or very good, but most of them reported therapy as being satisfactory or even unsatisfactory. This statement was in marked contrast to the much more positive global assessment made by physicians treating these patients. Patients report deficits in medical care with drugs. There is a clear need for action in relation to providing information to patients (explanation of side effects or differentiation of symptoms) and for a change of medication regimens to other compounds or combinations.

Schlüsselwörter

Behandlungsmuster - Therapiezufriedenheit - Selbstauskunft - Parkinson - Wirksamkeit

Keywords

treatment pattern - therapy satisfaction - self-assessment - Parkinson’s disease - effectiveness

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