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Predictors of clinically meaningful change in PDQ-39 in Parkinson's disease.
Parkinsonism Relat Disord. 2018 11; 56:93-97.PR

Abstract

OBJECTIVE

To determine predictors of clinically meaningful change in Health-Related Quality of Life (HRQL) in patients with Parkinson's disease (PD).

BACKGROUND

There is limited literature on longitudinal predictors of change in HRQL in PD.

METHODS

Data were collected from the National Parkinson Foundation Quality Improvement Initiative (NPF-QII) registry, a multicenter, longitudinal observational study. HRQL is measured by the Parkinson's Disease Questionnaire-39 (PDQ-39). We calculated the PDQ-39 change between every two consecutive visits and generated binary outcomes using the threshold for clinically meaningful change (previously determined to be 1.6). We used chi-squared tests for discrete and t-test for continuous variables for baseline characteristic comparison between patient groups of interest. Generalized linear mixed models with repeated measures were used for identifying the predictors of whether PDQ-39 outcomes worsen over time.

RESULTS

Of 8041 subjects enrolled, 5250 had at least one follow-up visit and were included in the analysis. Subjects were separated into two groups, "worse" and "not worse" based on PDQ-39 change >1.6 across consecutive visits. The "worse" group was more likely to be older (p = 0.001), to have motor fluctuations (p = 0.011), be on cognitive enhancers (p = 0.01), and to have more impaired immediate five-word recall (p = 0.04). The "non-worse" group was more likely to have rest tremor (p = 0.003), and to utilize social work/counseling (p = 0.046).

CONCLUSIONS

The majority of predictors of worsening of HRQL are baseline disease and demographic characteristics that are difficult to modify. The positive effect of social service/counseling is intriguing and important to further explore in controlled interventional studies.

Authors+Show Affiliations

Department of Neurology, Northwestern University, 303 East Chicago Avenue Ward 12-140, Chicago, IL, 60611, USA. Electronic address: margola@ccf.org.National Parkinson Foundation, 200 SE 1st Street, Suite 800, Miami, FL, 33131, USA. Electronic address: fcubillos@parkinson.org.Department of Mathematics, Clarkson University, 8 Clarkson Avenue, Potsdam, NY, 13699, USA. Electronic address: yhe@clarkson.edu.Department of Biostatistics, University of Florida, 2004 Mowry Road, 5th Floor CTRB P.O. Box 117450, Gainesville, FL, 32611, USA. Electronic address: sw45@ufl.edu.National Parkinson Foundation, 200 SE 1st Street, Suite 800, Miami, FL, 33131, USA. Electronic address: pschmidt@parkinson.org.Department of Neurology, Northwestern University, 303 East Chicago Avenue Ward 12-140, Chicago, IL, 60611, USA. Electronic address: tsimuni@nmff.org.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

30056039

Citation

Margolius, Adam, et al. "Predictors of Clinically Meaningful Change in PDQ-39 in Parkinson's Disease." Parkinsonism & Related Disorders, vol. 56, 2018, pp. 93-97.
Margolius A, Cubillos F, He Y, et al. Predictors of clinically meaningful change in PDQ-39 in Parkinson's disease. Parkinsonism Relat Disord. 2018;56:93-97.
Margolius, A., Cubillos, F., He, Y., Wu, S., Schmidt, P., & Simuni, T. (2018). Predictors of clinically meaningful change in PDQ-39 in Parkinson's disease. Parkinsonism & Related Disorders, 56, 93-97. https://doi.org/10.1016/j.parkreldis.2018.06.034
Margolius A, et al. Predictors of Clinically Meaningful Change in PDQ-39 in Parkinson's Disease. Parkinsonism Relat Disord. 2018;56:93-97. PubMed PMID: 30056039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of clinically meaningful change in PDQ-39 in Parkinson's disease. AU - Margolius,Adam, AU - Cubillos,Fernando, AU - He,Ying, AU - Wu,Samuel, AU - Schmidt,Peter, AU - Simuni,Tanya, AU - ,, Y1 - 2018/07/02/ PY - 2018/03/24/received PY - 2018/06/14/revised PY - 2018/06/30/accepted PY - 2018/7/30/pubmed PY - 2019/9/21/medline PY - 2018/7/30/entrez KW - Health-related quality of life KW - National Parkinson foundation quality improvement initiatives KW - PDQ-39 KW - Parkinson's disease KW - Quality of life SP - 93 EP - 97 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 56 N2 - OBJECTIVE: To determine predictors of clinically meaningful change in Health-Related Quality of Life (HRQL) in patients with Parkinson's disease (PD). BACKGROUND: There is limited literature on longitudinal predictors of change in HRQL in PD. METHODS: Data were collected from the National Parkinson Foundation Quality Improvement Initiative (NPF-QII) registry, a multicenter, longitudinal observational study. HRQL is measured by the Parkinson's Disease Questionnaire-39 (PDQ-39). We calculated the PDQ-39 change between every two consecutive visits and generated binary outcomes using the threshold for clinically meaningful change (previously determined to be 1.6). We used chi-squared tests for discrete and t-test for continuous variables for baseline characteristic comparison between patient groups of interest. Generalized linear mixed models with repeated measures were used for identifying the predictors of whether PDQ-39 outcomes worsen over time. RESULTS: Of 8041 subjects enrolled, 5250 had at least one follow-up visit and were included in the analysis. Subjects were separated into two groups, "worse" and "not worse" based on PDQ-39 change >1.6 across consecutive visits. The "worse" group was more likely to be older (p = 0.001), to have motor fluctuations (p = 0.011), be on cognitive enhancers (p = 0.01), and to have more impaired immediate five-word recall (p = 0.04). The "non-worse" group was more likely to have rest tremor (p = 0.003), and to utilize social work/counseling (p = 0.046). CONCLUSIONS: The majority of predictors of worsening of HRQL are baseline disease and demographic characteristics that are difficult to modify. The positive effect of social service/counseling is intriguing and important to further explore in controlled interventional studies. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/30056039/Predictors_of_clinically_meaningful_change_in_PDQ_39_in_Parkinson's_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(18)30302-X DB - PRIME DP - Unbound Medicine ER -