背景:不同类型的疗法被证明可有效治疗帕金森病(PD)的运动和非运动症状。我们旨在就多巴胺激动剂(DA)疗法在帕金森病(PD)患者的不同临床情况下的使用达成共识。
方法:本共识研究基于名义分组技术。最初,a由12名PD领域的神经科专家组成的共识小组确定了要解决的主题,并阐述了不同的基于证据的初步陈述。接下来,由48名西班牙神经学家组成的小组对基于互联网的系统投票计划发表了意见。最后,最初的想法根据小组的贡献进行了审查和重写,并由共识小组使用李克特型量表进行排名。采用定性和定量相结合的方法对数据进行分析。如果声明在投票过程中达到≥3.5分,就达成了共识。
结果:共识小组提出了76项现实世界建议。讨论的主题包括12项与PD早期DA治疗有关的声明,关于运动并发症患者DA治疗策略的20条声明,与DA药物及其副作用相关的11种陈述,和33份关于特定临床方案中DA治疗的声明。共识小组没有就15项声明达成共识。
结论:这种共识方法的发现代表了在PD的不同阶段和临床情况下帮助临床医生和患者适当使用DA的探索性步骤。
BACKGROUND: Different types of therapies were proven effective for the medical management of motor and non-motor symptoms in Parkinson\'s disease (PD). We aimed to gain
consensus on the dopamine agonist (DA) therapy use in different clinical scenarios of Parkinson\'s disease (PD) patients.
METHODS: This
consensus study was based on the nominal group technique. Initially, a consensus group comprising 12 expert neurologists in the PD field identified the topics to be addressed and elaborated different evidence-based preliminary statements. Next, a panel of 48 Spanish neurologists expressed their opinion on an internet-based systematic voting program. Finally, initial ideas were reviewed and rewritten according to panel contribution and were ranked by the consensus group using a Likert-type scale. The analysis of data was carried out by using a combination of both qualitative and quantitative methods. The
consensus was achieved if the statement reached ≥ 3.5 points in the voting process.
RESULTS: The
consensus group produced 76 real-world recommendations. The topics addressed included 12 statements related to DA therapy in early PD, 20 statements concerning DA treatment strategy in patients with motor complications, 11 statements associated with DA drugs and their side effects, and 33 statements regarding DA therapy in specific clinical scenarios. The
consensus group did not reach a
consensus on 15 statements.
CONCLUSIONS: The findings from this consensus method represent an exploratory step to help clinicians and patients in the appropriate use of DA in different stages and clinical situations of PD.