INTERNATIONAL RESEARCH & OPINION

Education improves QOL in patients with Parkinson's disease

Patient education and healthcare promotion can be effective adjuncts for managing Parkinson's disease, say researchers from the US PROPATH Advisory Board. *

Their 6-month, controlled trial involved 290 patients with Parkinson's disease who were randomised to the intervention or control group. The intervention group completed a questionnaire at time of study entry and at 2, 4 and 6 months follow-up. After analysis of the survey results, the intervention participants received a recommendation letter, reviewing their progress over time, as well as educational material about their condition. At 6 months, a battery of quality-of-life (QOL) questions (including on-score and off-score from the Unified Parkinson's Disease Rating Scale and a global assessment) were administered to both patient groups.

Programme reduces disease progression At 6 months, the intervention group experienced

significant improvements in on-score, off-score, summary Parkinson's scores and adverse effects; in contrast, these variables deteriorated in the control group. There was also a significant improvement in self-efficacy beliefs about symptom control, timed function of daily activities and the management of disease problems among intervention participants.

Interestingly, the dose of levodopa was maintained in the intervention group over the 6-month period, while the dose of levodopa and other drugs increased significantly in the control group, report the researchers. Exercise increased significantly in the intervention, compared with the control, group. Notably, intervention recipients had fewer physician visits, hospitalisations and sick days, compared with the control group.

Overall costs lower in the intervention group Based on the assumptions that a physician visit

costs $US 100, hospitalisation costs $1000/day and a sick day costs $200, then the intervention would lead to cost savings of $820/patient over a 6-month period, say the researchers. The PROPArn programme cost an estimated $100/patientlyear, generating a cost: benefit ratio of around 1: 12, they add. * The objective of the PROPATH Program was to improve functional outcome in patients with Parkinson s disease involved in an educational strategy designed to improve their self-efficacy, confidence and physical functioning through exercise. Also, the programme provides infonnation and recommendations to patients and their physicians.

Montgomery Jr EB. Lieberman A, Singh O. PROPATII Advisory Board, et al. Patient education and health promotion can be effective in Parkinson's disease: a randomized controlled trial. American Journal of Medicine 97: 429-435, Nov 1994 Il00320846

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