Impact of Device-aided Therapies on Quality of Life in Patients with Parkinson´s Disease. A Comparative Multicenter Observational Study.

Background and objective: Device aided-therapies (DATs) improve health-related quality of life (HRQoL) in patients with Parkinson´s disease (PwP). However, no studies comparing all DATs have been conducted to date. Our aim was to compare the effect of different DATs on HRQoL and other disease-related variables in PwP. Patients and Methods: Data from baseline (V1) and the 6-month follow-up visit (V3.6M) were collected from a descriptive, observational, prospective, multicenter, clinical registry conducted in Spain entitled DATs-PD GETM Spanish Registry. The primary endpoint was the change from V1 to V3.6M in the 39-item Parkinson's Disease Questionnaire (PDQ-39) total score. Relative change (RC) and Cohen´s d (d) effect were applied. The effect over many other variables was also analyzed. Results HRQoL improved significantly in the entire cohort (N = 137) with a moderate decrease of 13.4% in the PDQ-39 total score (from 58.9 ± 22.9 at V1 to 51.0 ± 26.8 at V3.6M; d = 0.51; p < 0.0001). No differences in the change of the PDQ-39 total score were detected between both subcutaneous therapies (i.e., foslevodopa/foscarbidopa [fLD/fCD] and continuous subcutaneous apomorphine infusion [CSAI]; p = 0.666) and between subcutaneous and enteral therapies (p = 0.721). Although a greater improvement in HRQoL was observed in PwP treated with deep brain stimulation (DBS) (N = 30; RC=-26.3%; d = 0.83; p = 0.002) compared to those who received a pump system (N = 107; RC=-10.2%; d = 0.41; p = 0.003) (p = 0.009), the effect was not significant after adjustment to age, sex, and disease duration (p = 0.161). Off time, dyskinesia, motor symptoms, and non-motor symptoms improved significantly in the entire cohort. Conclusion HRQoL improved in PwP after being treated with a DAT.