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dc.contributor.authorOdin, P
dc.contributor.authorRay Chaudhuri, K
dc.contributor.authorSlevin, J T
dc.contributor.authorVolkmann, J
dc.contributor.authorDietrichs, E
dc.contributor.authorMartínez-Martín, Pablo 
dc.contributor.authorKrauss, J K
dc.contributor.authorHenriksen, T
dc.contributor.authorKatzenschlager, R
dc.contributor.authorAntonini, A
dc.contributor.authorRascol, O
dc.contributor.authorPoewe, W
dc.contributor.authorNational Steering Committees
dc.date.accessioned2022-05-25T11:16:53Z
dc.date.available2022-05-25T11:16:53Z
dc.date.issued2015-10
dc.identifier.citationParkinsonism Relat Disord. 2015 Oct;21(10):1133-44.es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/14528
dc.description.abstractNavigate PD was an educational program established to supplement existing guidelines and provide recommendations on the management of Parkinson's disease (PD) refractory to oral/transdermal therapies. It involved 103 experts from 13 countries overseen by an International Steering Committee (ISC) of 13 movement disorder specialists. The ISC identified 71 clinical questions important for device-aided management of PD. Fifty-six experts responded to a web-based survey, rating 15 questions as 'critically important;' these were refined to 10 questions by the ISC to be addressed through available evidence and expert opinion. Draft guidance was presented at international/national meetings and revised based on feedback. Key take-home points are: • Patients requiring levodopa >5 times daily who have severe, troublesome 'off' periods (>1-2 h/day) despite optimal oral/transdermal levodopa or non-levodopa-based therapies should be referred for specialist assessment even if disease duration is <4 years. • Cognitive decline related to non-motor fluctuations is an indication for device-aided therapies. If cognitive impairment is mild, use deep brain stimulation (DBS) with caution. For patients who have cognitive impairment or dementia, intrajejunal levodopa infusion is considered as both therapeutic and palliative in some countries. Falls are linked to cognitive decline and are likely to become more frequent with device-aided therapies. • Insufficient control of motor complications (or drug-resistant tremor in the case of DBS) are indications for device-aided therapies. Levodopa-carbidopa intestinal gel infusions or subcutaneous apomorphine pump may be considered for patients aged >70 years who have mild or moderate cognitive impairment, severe depression or other contraindications to DBS.es_ES
dc.description.sponsorshipMedical writing support was provided by Emma East and Lindy van den Berghe at Lucid Group and funded by AbbVie.es_ES
dc.language.isoenges_ES
dc.publisherElsevier es_ES
dc.type.hasVersionVoRes_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectParkinson's diseasees_ES
dc.subjectDevice-aided therapieses_ES
dc.subjectMotor fluctuationses_ES
dc.subjectDyskinesiases_ES
dc.subjectNon-motor symptomses_ES
dc.subject.meshConsensus es_ES
dc.subject.meshHumans es_ES
dc.subject.meshOrthopedic Equipment es_ES
dc.subject.meshParkinson Disease es_ES
dc.subject.meshSurveys and Questionnaires es_ES
dc.titleCollective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson's disease: Consensus from an international survey and discussion programes_ES
dc.typejournal articlees_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.identifier.pubmedID26233582es_ES
dc.format.volume21es_ES
dc.format.number10es_ES
dc.format.page1133-44es_ES
dc.identifier.doi10.1016/j.parkreldis.2015.07.020es_ES
dc.contributor.funderAbbVie es_ES
dc.description.peerreviewedes_ES
dc.identifier.e-issn1873-5126es_ES
dc.relation.publisherversionhttps://doi.org/10.1016/j.parkreldis.2015.07.020es_ES
dc.identifier.journalParkinsonism & Related Disorderses_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.repisalud.institucionISCIIIes_ES
dc.rights.accessRightsopen accesses_ES


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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
Este Item está sujeto a una licencia Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 Internacional