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A Patient-Based Needs Assessment for Living Well with Parkinson Disease: Implementation via Nominal Group Technique

DOI: 10.1155/2013/974964

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Abstract:

Background. Parkinson’s disease (PD) is a neurodegenerative condition with complex subtleties, making it challenging for physicians to fully inform their patients. Given that approximately 50% of Americans access the Internet for health information, the development of a multimedia, web-based application emphasizing targeted needs of people with Parkinson’s disease (PwP) has the potential to change patient’s lives. Objectives. To determine what information PwP perceive could enhance their quality of life. Methods. Group sessions utilizing nominal group technique (NGT) were conducted. Participants were asked “what information do you want to know about that would help you live well with PD?” Silent generation of ideas preceded discussion followed by anonymous ranking of items. A “summary score” (sum of rank × frequency) was calculated. Results. 36 individual items were collapsed into 9 categories. Coping with emotions, changing relationships, and social implications of PD were ranked as most important. Financial supports and skills for self-advocacy were also highly ranked. Conclusions. Qualitative research methodology was utilized to determine the unmet needs of PwP. Results of this survey will inform the development of a patient-oriented, online resource, the goal will be to provide information and strategies to improve symptom management, reduce disability and address all relevant concerns important to those affected by PD. 1. Introduction The incidence of Parkinson’s disease (PD) increases with advancing age, and incidence exceeds 1% after age 65, and 3% after age 80 [1]. The prevalence of PD in those over 80 is projected to double over the next 30 years (from 11.6% to 23.6%) as life expectancy in the elderly increases. In 1998, an estimate of annual PD-related costs in Canada exceeded $560 million, with 70% of these costs related to long-term disability [2]. As with prevalence, the socioeconomic impact of PD is projected to increase dramatically; in Canada, health cost inflation and an aging population are likely to result in costs of almost $1 billion annually in the coming decades. Costs related to lost income for both people living with PD (PwP) and caregivers, and intangible costs associated with emotional anguish, are likely also large [3–7]. The progressive nature of PD symptoms results in profound reduction in quality of life that in some cases can be rated worse than death (based on commonly used health utility measures [8]). Evidence, knowledge, and strategies to delay functional decline in PD do exist. A recent study showed that

References

[1]  D. Hirtz, D. J. Thurman, K. Gwinn-Hardy, M. Mohamed, A. R. Chaudhuri, and R. Zalutsky, “How common are the “common” neurologic disorders?” Neurology, vol. 68, no. 5, pp. 326–337, 2007.
[2]  Health Canada. Economic Burden of Illness in Canada, Government of Canada, Ottawa, Canada, 1998, http://www.phac-aspc.gc.ca/publicat/ebic-femc98/pdf/ebic1998.pdf.
[3]  J. J. Chen, “Parkinson's disease: health-related quality of life, economic cost, and implications of early treatment,” The American Journal of Managed Care, vol. 16, supplement, pp. S87–S93, 2010.
[4]  Y. Winter, M. Balzer-Geldsetzer, A. Spottke et al., “Longitudinal study of the socioeconomic burden of Parkinson's disease in Germany,” European Journal of Neurology, vol. 17, no. 9, pp. 1156–1163, 2010.
[5]  R. C. Dodel, M. Singer, R. K?hne-Volland et al., “The economic impact of Parkinson's disease: an estimation based on a 3- month prospective analysis,” Pharmaco Economics, vol. 14, no. 3, pp. 299–312, 1998.
[6]  M. Pugliatti, P. Sobocki, E. Beghi et al., “Cost of disorders of the brain in Italy,” Neurological Sciences, vol. 29, no. 2, pp. 99–107, 2008.
[7]  E. A. Spottke, J. Volkmann, D. Lorenz et al., “Evaluation of healthcare utilization and health status of patients with Parkinson's disease treated with deep brain stimulation of the subthalamic nucleus,” Journal of Neurology, vol. 249, no. 6, pp. 759–766, 2002.
[8]  G. Kleiner-Fisman, M. B. Stern, and D. N. Fisman, “Health-Related Quality of Life in Parkinson disease: correlation between Health Utilities Index III and Unified Parkinson's Disease Rating Scale (UPDRS) in U.S. Male veterans,” Health and Quality of Life Outcomes, vol. 8, article 91, 2010.
[9]  L. E. I. A'Campo, E. M. Wekking, N. G. A. Spliethoff-Kamminga, S. Le Cessie, and R. A. C. Roos, “The benefits of a standardized patient education program for patients with Parkinson's disease and their caregivers,” Parkinsonism and Related Disorders, vol. 16, no. 2, pp. 89–95, 2010.
[10]  L. Tickle-Degnen, T. Ellis, M. H. Saint-Hilaire, C. A. Thomas, and R. C. Wagenaar, “Self-management rehabilitation and health-related quality of life in Parkinson's disease: a randomized controlled trial,” Movement Disorders, vol. 25, no. 2, pp. 194–204, 2010.
[11]  A. W. Willis, M. Schootman, B. A. Evanoff, J. S. Perlmutter, and B. A. Racette, “Neurologist care in Parkinson disease: a utilization, outcomes, and survival study,” Neurology, vol. 77, pp. 851–857, 2011.
[12]  E. R. Dorsey, T. S. Voss, D. R. Shprecher et al., “A U.S. Survey of patients with Parkinson's disease: satisfaction with medical care and support groups,” Movement Disorders, vol. 25, no. 13, pp. 2128–2135, 2010.
[13]  E. M. Cheng, K. Swarztrauber, A. D. Siderowf et al., “Association of specialist involvement and quality of care for Parkinson's disease,” Movement Disorders, vol. 22, no. 4, pp. 515–522, 2007.
[14]  P. Hartzband and J. Groopman, “Untangling the web—patients, doctors, and the internet,” The New England Journal of Medicine, vol. 362, no. 12, pp. 1063–1066, 2010.
[15]  L. Baker, T. H. Wagner, S. Singer, and M. K. Bundorf, “Use of the internet and E-mail for health care information: results from a national survey,” Journal of the American Medical Association, vol. 289, no. 18, pp. 2400–2406, 2003.
[16]  P. R. Fitzsimmons, B. D. Michael, J. L. Hulley, and G. O. Scott, “A readability assessment of online Parkinson's disease information,” The Journal of the Royal College of Physicians of Edinburgh, vol. 40, pp. 292–296, 2010.
[17]  C. Moore, Applied Social Research Methods Series, Sage, Thousand Oaks, Cali, USA, 1994.
[18]  S. O'Donnell, D. Kennedy, A. M. MacLeod, C. Kilroy, and J. Gollish, “Achieving team consensus on best practice rehabilitation guidelines following primary total hip replacement (THR) surgery,” Healthcare Quarterly, vol. 9, no. 4, pp. 60–64, 2006.
[19]  N. Harvey and C. A. Holmes, “Nominal group technique: an effective method for obtaining group consensus,” International Journal of Nursing Practice, vol. 18, pp. 188–194, 2012.
[20]  A. Sales, H. M. O'Rourke, K. Draper, G. F. Teare, and C. Maxwell, “Prioritizing information for quality improvement using resident assessment instrument data: experiences in one Canadian province,” Healthcare Policy, vol. 6, no. 3, pp. 55–67, 2011.
[21]  A. Pena, C.A. Estrada, D. Soniat, B. Taylor, and M. Burton, “Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients,” Journal of Hospital Medicine, vol. 7, no. 5, pp. 416–420, 2011.
[22]  G. B. A. Guest and L. Johnson, “How many interviews are enough? An experiment with data saturation and variability,” Field, vol. 18, no. 1, pp. 59–82, 2006.
[23]  G. Kleiner-Fisman, R. Martine, A. E. Lang, and M. B. Stern, “Development of a non-motor fluctuation assessment instrument for Parkinson disease,” Parkinson's Disease, vol. 2011, Article ID 292719, 13 pages, 2011.
[24]  I. O. Medicine, Crossing the Quality Chasm. A New Health Sysem for the 21st Century, National Academy Press, Washington, DC, USA, 2001.
[25]  J. A. Osheroff, J. M. Teich, B. Middleton, E. B. Steen, A. Wright, and D. E. Detmer, “A roadmap for national action on clinical decision support,” Journal of the American Medical Informatics Association, vol. 14, no. 2, pp. 141–145, 2007.
[26]  M. Macht, R. Schwarz, and H. Ellgring, “Patterns of psychological problems in Parkinson's disease,” Acta Neurologica Scandinavica, vol. 111, no. 2, pp. 95–101, 2005.
[27]  H. Ellgring, S. Seiler, B. Perleth, W. Frings, T. Gasser, and W. Oertel, “Psychosocial aspects of Parkinson's disease,” Neurology, vol. 43, no. 12, supplement 6, pp. S41–S44, 1993.
[28]  E. M. Cheng, S. Tonn, R. Swain-Eng, S. A. Factor, W. J. Weiner, and C. T. Bever Jr., “Quality improvement in neurology: AAN Parkinson disease quality measures: report of the Quality Measurement and Reporting Subcommittee of the American Academy of Neurology,” Neurology, vol. 75, no. 22, pp. 2021–2027, 2010.
[29]  S. Johnson, M. Davis, A. Kaltenboeck, et al., “Early retirement and income loss in patients with early and advanced Parkinson's disease,” Applied Health Economics and Health Policy, vol. 9, pp. 367–376, 2011.
[30]  M. van der Eijk, M. J. Faber, S. Al Shamma, M. Munneke, and B. R. Bloem, “Moving towards patient-centered healthcare for patients with Parkinson's disease,” Parkinsonism and Related Disorders, vol. 17, no. 5, pp. 360–364, 2011.
[31]  C. J. L. Murray and D. Evans, “Health systems performance assessment,” in Debates, Methods, and Empiricism, World Health Organization, Geneva, Switzerland, 2003.
[32]  K. A. Grosset and D. G. Grosset, “Patient-perceived involvement and satisfaction in Parkinson's disease: effect on therapy decisions and quality of life,” Movement Disorders, vol. 20, no. 5, pp. 616–619, 2005.

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