Effect of Home-Based Self-Management Intervention for Community-Dwelling Patients with Early Parkinson's Disease: A Feasibility Study.

PURPOSE: This study aimed to evaluate the effect of a home-based self-management intervention in community-dwelling patients with early Parkinson's diseases (PD). DESIGN: A randomized-controlled design. METHODS: Thirty-two patients participated (15=intervention, 17=control), and the intervention group received 16 weeks of the intervention. FINDINGS: Physical activity and non-motor symptoms improved more in the intervention group than in the control group. CONCLUSION: Home-based self-management intervention was effective in improving physical activity and non-motor symptoms for them. CLINICAL EVIDENCE: Home-based intervention - comprising education, telephone counseling, smartphone-based message and information, and smart wearable devices - was feasible for patients with early PD.

Effect of mobile health intervention for self-management on self-efficacy, motor and non-motor symptoms, self-management, and quality of life in people with Parkinson's disease: Randomized controlled trial.

OBJECTIVES: To evaluate the effects of a mobile health intervention for self-management on self-efficacy, motor and non-motor symptoms, self-management, and quality of life in people with Parkinson's disease. METHODS: A randomized controlled design was used. The participants were randomly assigned to an intervention or a control group. The intervention group (n = 20) received mobile health intervention comprising mobile applications, smartwatches, smartphone-based short text messages and information, and telephone counselling; whereas the control group (n = 23) received short text messages and telephone counselling for 16 weeks. RESULTS: After 16 weeks, self-efficacy and non-motor symptom scores in the intervention group significantly improved compared to those in the control group. However, no significant differences were observed in the motor symptoms, self-management, and quality of life between the groups. CONCLUSIONS: The mobile health intervention for self-management is effective for self-efficacy and non-motor symptoms in people with Parkinson's disease.

Factors Associated with Medication Beliefs in Patients with Parkinson's Disease: A Cross-Sectional Study.

OBJECTIVE: Medication beliefs are a significant determinant of medication adherence in chronic illness. This study aimed to identify demographic, clinical, and medication-related factors associated with medication beliefs in patients with Parkinson's disease (PD). METHODS: We used a descriptive cross-sectional design with a convenience sample of 173 PD patients who had been taking antiparkinson drugs for more than one year. RESULTS: The subjects who believed PD medication was more necessary had more severe illness, younger age of onset, longer illness duration, and longer duration of levodopa therapy. They had higher levels of non-motor symptoms and depression, number of medication uses, number of drugs, and levodopa equivalent dose, and they reported fluctuation of motor symptoms and dyskinesia. The subjects who used catechol-O-methyltransferase (COMT) inhibitors, dopamine agonists, amantadine, and monoamine oxidase-B (MAO-B) inhibitors had significantly higher necessity scores than those who did not use them. The subjects who had higher concerns about PD medications had higher levels of non-motor symptoms and depression. The subjects using amantadine and anticholinergics had significantly higher concern scores than those who did not use them. Positive necessity-concerns differentials were associated with severe illness, the presence of motor fluctuation and dyskinesia, and the use of COMT inhibitors. Based on stepwise multiple regression, the most significant factors influencing necessity beliefs were severe illness, followed by depression and motor fluctuation. CONCLUSION: Severe illness, higher levels of depression, and motor fluctuation are independent factors influencing patients' beliefs regarding medication necessity. Therefore, these characteristics should be considered in medication belief assessment and interventions for PD patients.

Influencing effect of non-motor symptom clusters on quality of life in Parkinson's disease.

The heterogeneity of non-motor symptoms (NMSs) in patients with Parkinson's disease (PD) has been well established. We investigated the effects of NMS as a cluster on the quality of life (QoL) of patients with PD. We recruited 180 patients with PD and used a descriptive cross-sectional study design. To determine interrelationships between non-motor symptoms, a principal component analysis with varimax rotation was performed based on the Non-Motor Symptoms Scale (NMSS). Among 180 PD patients, 172 patients (96.6%) had experienced at least 2 domains of concurrent non-motor symptoms. There were two types of non-motor symptom clusters (NMSCs). The first non-motor symptom cluster (NMSC1) consisted of mood, sleep/fatigue, attention/memory, urinary symptoms, and miscellaneous symptoms, while the second non-motor symptom cluster (NMSC2) consisted of perceptual problems, gastrointestinal issues, and cardiovascular symptoms. The elderly PD patients were more often categorized as experiencing NMSC2 than NMSC1. Our subgroup cluster analysis showed that PD patients with higher scoring NMS had significantly poorer QoL in both NMSC1 and NMSC2 subgroups, with subgroup-specific patterns. NMSCs also emerged differently depending on sex and the severity of PD. In conclusion, PD patients with NMS may have a specific cluster pattern of NMSC. Some NMSCs may have a negative impact on QoL. Understanding the clinical implications of NMSC in PD patients may provide better therapeutic interventions.