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Abstracts from the International Congress of Parkinson’s and Movement Disorders.

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On-demand therapy (ODT) in Parkinson’s disease: a survey of advanced practice providers

K. Papesh, A. Merriam, C. Zebendon (Phoenix, USA)

Meeting: 2023 International Congress

Abstract Number: 1419

Keywords: Parkinson’s, Pharmacotherapy, Wearing-off fluctuations

Category: Parkinson’s Disease: Pharmacology and Therapy

Objective: A survey of neurology Advanced Practice Providers (APPs) provides insights into their perspectives on managing and treating patients with Parkinson’s disease (PD) in the US healthcare industry, with an emphasis on the use of ODT.

Background: APPs are an essential part of the multidisciplinary team for managing patients with PD. To better understand their role in managing PD and to learn about their experiences in prescribing ODT and treating PD, a survey of APPs was initiated by the PMD Alliance.

Method: The survey was developed using surveymonkey.com. It consisted of 22 questions that provide insights into APP demographics, their role in the management of patients with PD, and their attitude toward and use of ODT.

Results: To date, the survey has 27 respondents (70% nurse practitioners and 30% physician assistants/associates). >80% independently see new and follow-up patients, prescribe new therapies, or change maintenance therapies. 74.1% believe it is difficult to manage PD with baseline therapies. 88.9% prescribe ODT, only 30% prescribe frequently. All respondents agree that it is important to recognize the emotional impact of OFF periods, and 81.4% agree that ODT offers patients control over returning symptoms, increasing their confidence. 96.3% of APPs ask about specific symptoms at all or nearly all visits, yet only 33.3% ask if the patient has stopped engaging in social activities for fear of returning symptoms. 96.3% answered that the impact of OFF periods on lifestyle was important when considering ODT. Factors “always” considered when prescribing ODT were affordability (74.1%) and bothersome OFF periods impacting activities (59.6%), yet only 37.0% “always” consider the emotional impact of OFF periods. 51.9% ranked the most important benefit of ODT treatment as enabling more control over PD symptoms, and 25.9% ranked ODT’s rapid onset of action. On average, respondents believe ~40% of patients with PD in their practices could benefit from an ODT. The main reason given for not prescribing ODT was affordability (70.4%). Further data will be presented at the meeting.

Conclusion: APPs play important roles in treating PD. Prioritizing the consideration of the emotional impact of living with OFF periods at most or all office visits may provide an opportunity for increased use of ODT and thus reduce the burden of unexpected symptom return for patients.

To cite this abstract in AMA style:

K. Papesh, A. Merriam, C. Zebendon. On-demand therapy (ODT) in Parkinson’s disease: a survey of advanced practice providers [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/on-demand-therapy-odt-in-parkinsons-disease-a-survey-of-advanced-practice-providers/. Accessed May 9, 2025.
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