# Patients' Preferences for Parkinson's Disease Pharmacotherapy: An Online Discrete Choice Experiment

## TL;DR

This study explores what Japanese Parkinson's disease patients value most in their medications, such as effectiveness and side effects, to help doctors provide more personalized care.

## Contribution

The study identifies specific patient preferences for PD medications using a discrete choice experiment in a Japanese population.

## Key findings

- Patients most valued the risk of dyskinesia, symptom improvement, and other side effects.
- Three distinct patient groups with different preferences were identified based on disease severity and backgrounds.
- Moving difficulty/slow movement was the most important symptom patients wanted to improve.

## Abstract

Background: There are many pharmacological treatment options beyond levodopa for Parkinson's disease (PD), with a variety of drug classes and formulations available. To achieve patient-centered care, clinicians must consider patients' backgrounds and preferences when selecting medications.

Objectives: To investigate medication preferences regarding efficacy, safety, dosage/formulation, and cost in Japanese PD patients.

Methods: Adults (18–90 years) from the Japan Parkinson's Disease Association receiving PD medication were eligible. An online survey was conducted, involving a discrete choice experiment, which set five medication characteristics including improvement of bothersome symptoms, risk of dyskinesia, risk of side effects other than dyskinesia, dosage/formulation, and monthly out-of-pocket cost. A questionnaire about the value of efficacy and safety of PD medications was also included.

Results: In the full analysis set (N = 207), the mean age was 65.2 years, 53.1% were female, and 62.8% had wearing-off. The most impotrant characteristics of PD medications for patients were the risk of dyskinesia, improvement of bothersome symptoms, and risk of side effects other than dyskinesia. Latent class analysis identified three groups with different preferences who have varied backgrounds, such as disease severity. The three most important symptoms patients wanted to improve were moving difficulty/slow movement (79.7%), body stiffness (43.5%), and pain (42.0%). The three most important side effects patients wanted to avoid were dyskinesia (54.6%), hallucinations/visual hallucinations (19.3%), and constipation (11.6%).

Conclusion: PD patients placed the highest importance on the risk of dyskinesia for PD medications and also efficacy. To achieve patient-centered care, clinicians should consider patients' backgrounds and preferences when selecting medications.