Feasibility and benefits of home initiation of subcutaneous apomorphine infusion for patients with Parkinson's disease: the APOKADO study.
Apomorphine
Home care
Parkinson’s disease
Quality of life
Journal
Journal of neural transmission (Vienna, Austria : 1996)
ISSN: 1435-1463
Titre abrégé: J Neural Transm (Vienna)
Pays: Austria
ID NLM: 9702341
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
14
01
2023
accepted:
20
02
2023
medline:
15
11
2023
pubmed:
3
3
2023
entrez:
2
3
2023
Statut:
ppublish
Résumé
Continuous subcutaneous apomorphine infusion (CSAI) is used to treat patients with Parkinson's disease (PD) who are experiencing motor fluctuations. However, the need to initiate this treatment during a hospital stay may restrict patients' access to it. To assess the feasibility and benefits of initiating CSAI in the patient's own home. A French prospective multicenter longitudinal observational study (APOKADO) among patients with PD who required subcutaneous apomorphine, comparing in-hospital versus home initiation. Clinical status was assessed according to the Hoehn and Yahr score), the Unified Parkinson's Disease Rating Scale Part III, and the Montreal Cognitive Assessment. We assessed patients' quality of life with the 8-item Parkinson's Disease Questionnaire, rated the improvement in their clinical status on the 7-point Clinical Global Impression-Improvement scale, recorded adverse events, and ran a cost-benefit analysis. 145 patients with motor fluctuations were included in 29 centers (office and hospital). Of these, 106 (74%) were initiated onto CSAI at home, and 38 (26%) in hospital. At inclusion, the two groups were comparable for all demographic and PD characteristics. After 6 months, quality of life, adverse events and early dropout rates were similarly rare-across the two groups. Patients in the home group improved more quickly their quality of life and became more autonomous in managing the device than those in the hospital group, and their care costed less. This study shows that home (versus in-hospital) initiation of CSAI is feasible, improves patients' quality of life more quickly, with the same level of tolerance. It is also less expensive. This finding should make it easier for patients to access this treatment in the future.
Identifiants
pubmed: 36862190
doi: 10.1007/s00702-023-02609-6
pii: 10.1007/s00702-023-02609-6
pmc: PMC9979890
doi:
Substances chimiques
Apomorphine
N21FAR7B4S
Antiparkinson Agents
0
Levodopa
46627O600J
Types de publication
Observational Study
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1463-1474Investigateurs
Andrei Arhire
(A)
Philippe Barres
(P)
Maxime Blondiaux
(M)
Jean-Claude Bouffeteau
(JC)
Jean-Philippe Brandel
(JP)
Christophe Carel
(C)
Giovanni Castelnovo
(G)
Marc Coustans
(M)
Lucie Courault
(L)
Christian Crauser
(C)
Isabelle Degaey
(I)
Bertrand Degos
(B)
Jean-Philippe Delabrousse
(JP)
Béatrice Denis
(B)
Marie-Claude Dourneau
(MC)
Arnaud Duretete
(A)
Jean-Marc François Feve
(JF)
Erika Follin
(E)
Michel Gugenheim
(M)
Cécile Hubsch
(C)
Nathalie Patte Karsenti
(N)
Pierre Louchart
(P)
Serge Massengo
(S)
José Mejias
(J)
Homero Monteiro
(H)
Philippe Muh
(P)
Bernard Pedespan
(B)
Virginie Sattler
(V)
Mathieu Sevin
(M)
Mélissa Tir
(M)
Anne Tirel Badets
(A)
Marc Verin
(M)
Irina Viakhireva
(I)
Elisabeth Vidry
(E)
Jean-Charles Wiart
(JC)
Informations de copyright
© 2023. The Author(s).
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