The Patient Card questionnaire to identify wearing-off in Parkinson disease

This study sought to evaluate the feasibility and performance of the Patient Card (PC), an instrument derived from the Patient Questionnaire by Stacy et al, for detection of wearing-off (W-O), in a very first application to a Spanish population with Parkinson disease. Patients were classified as experiencing W-O on the basis of the clinician's Follow-up Questionnaire, the Unified Parkinson Disease Rating Scale-Item 36, or improvement, after the following scheduled dose of medication, of 1 or more symptoms included in the PC. The highest proportion of patients with W-O was identified by the PC (79.8%), followed by the Follow-up Questionnaire (55.4%), and Unified Parkinson Disease Rating Scale (35.1%) (Cochran Q, P < 0.01). The PC Spanish version performed adequately, capturing W-O symptoms more frequently than did the other methods, as in the original Patient Questionnaire study by Stacy et al. Accordingly, the PC may potentially help clinicians identify W-O phenomena and thereby allow for better management of patients with Parkinson disease.