A modified Delphi consensus study to support and enhance Parkinson's disease management

Area of Science:

• Neurology
• Movement Disorders

Background:

• Levodopa remains the primary symptomatic treatment for Parkinson's disease (PD).
• Long-term use and disease progression in people with Parkinson's disease (PwP) can lead to motor complications like wearing off and dyskinesia.
• Clinical practice lacks clear guidance for early identification of motor fluctuations and optimal adjunctive therapy timing.

Purpose of the Study:

• To establish expert consensus on best practices for levodopa therapy initiation and monitoring in PD.
• To define strategies for recognizing early motor fluctuations and integrating adjunctive therapies.
• To improve patient and caregiver education for enhanced PD management.

Main Methods:

• A modified Delphi methodology was employed.
• A steering committee drafted 59 consensus statements, which were surveyed among UK healthcare professionals (HCPs).
• Consensus was defined as ≥75% agreement on a four-point Likert scale.

Main Results:

• All 59 statements achieved 100% consensus among 150 participating HCPs.
• Key agreements include aligning treatment with patient goals, routine monitoring with standardized tools, and timely adjunctive therapy initiation.
• Emphasis was placed on accessible, ongoing education for patients and caregivers.

Conclusions:

• This Delphi consensus offers expert-derived, practical recommendations for proactive, individualized PD management.
• Implementing these recommendations can improve recognition and treatment of motor fluctuations.
• Adoption of these practices is expected to enhance patient quality of life and long-term outcomes in PD.