Objective: The study aims to evaluate treatment preferences and factors influencing decisions following structured Parkinson Disease Nurse Specialist (PDNS)-led Device Assisted Therapy (DAT) education.

Background: DATs improve motor fluctuations in Parkinson disease (PD) compared to oral therapy by providing continuous stimulation. In Australia, DATs include apomorphine injections (APO INJ) and infusions (APO INF), levodopa-carbidopa intestinal gel (LCIG), and deep brain stimulation (DBS). Initiating DATs require patient education to support informed decisions. PDNS-led education provides evidence-based information, corrects misconceptions, ensure awareness of therapies while aligning treatment decisions with patient lifestyles.

Method: A retrospective review of 143 PD patients between 2018 to 2025 was conducted. All attended PDNS-led education virtually or in person and received a non-biased presentation of the four available DATs. Data included age, disease duration, modality, treatment rankings, decision status, and reasons for choice. Multivariable logistic regression models identified variables associated with DAT selection, with DAT choice as the dependent variable and age, PD duration, gender, total daily dose (TDD), and modality as independent variables.

Results: Among 143 patients (mean age 64.1 years), 66.4% were male. Mean disease duration was 9.2 years with 1337mg TDD. Telehealth accounted for 73%. Following education, 58% proceeded with therapy, 35% remained undecided, and 7% declined. APO INJ was most selected as first choice (54.5%), followed by DBS (31.5%). LCIG was frequently ranked fourth (54.5%). Preferences were influenced by reversibility and invasiveness. Age was associated with a choice of DBS (OR 0.95 95% CI 0.91 to 0.99 p=0.022) and LCIG (OR 1.08, 95% CI 1.01 to 1.15 p = 0.019) but not other DATs. No other variables were associated with DAT selection. In summary, younger, male patients favoured DBS, while females and older adults preferred less invasive options.

Conclusion: Structured PDNS-led education supported informed decision-making regarding DATs. Preferences were influenced by invasiveness and reversibility with younger patients favouring DBS and older patients preferring less invasive therapies. These findings highlight the role of targeted nurse-led education in guiding patient choices and promoting shared decision-making.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/device-assisted-therapies-in-parkinson-disease-patient-preference-following-nurse-led-education/