Objective: To develop an expert consensus on personalised treatment selection in advanced Parkinson’s disease (aPD) patients who are considered suitable for transition to device-aided therapies (DATs), incorporating both clinical and patient/caregiver perspectives.

Background: DATs, including deep-brain stimulation and infusion therapies, are commonly used in aPD management, but criteria for individual treatment selection and structured guidance on how to transition from other therapies are limited. Currently available DATs appear to provide broadly comparable motor efficacy, therefore other factors such as tolerability profile, individual patient characteristics and practical considerations (patient preferences, capabilities and availability carer support), will impact treatment selection.

Method: A panel of neurologists and movement disorder specialists from eight European countries designed a four‑meeting Delphi process. A total of 169 statements regarding the determinants of DAT selection, clinical and healthcare system barriers, and knowledge gaps in the current treatment landscape were evaluated. Two questionnaire rounds were distributed to an expanded faculty. In parallel, a two‑part splinter programme used a change management approach with a patient–caregiver workshop of individuals who had received or considered DAT treatment, exploring expectations, decision‑making, practical burden, emotional impact, and support needs.

Results: Final Delphi statements and splinter‑group outputs were integrated into expert opinion proposals to develop practical recommendations regarding the wide range of factors beyond clinical efficacy that impact DAT choice, including individual patient characteristics, capabilities and preferences, and availability of carer support. These factors are essential for developing a personalised treatment plan for aPD patients.

Conclusion: This combined Delphi panel and splinter‑group programme generated consensus statements and recommendations for selection of DAT in aPD, that incorporate patient and caregiver perspectives. The recommendations aim to support informed treatment choice, structured sequencing of therapies, and improved preparation and support for patients and their caregivers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/personalised-selection-of-device-aided-infusion-therapies-in-advanced-parkinsons-disease-a-european-expert-delphi-consensus/