Patient Referral for Device-Aided Therapies in Parkinson's Disease is Suboptimal; A Dutch Survey

Summary: Motor fluctuations (MF) are a troublesome disease feature for patients with Parkinson's disease (PD) due to the increasing impairment in responsiveness to dopaminergic drug treatments. MF are characterized by the loss of a stable response to levodopa over the day and night, and they normally appear after a few years of treatment with levodopa. The management of MF includes various treatment options such as new compounds, on-demand therapies, and advanced therapies. The choice of treatment depends on physician opinion, patient preference, caregiver availability, and public health systems and socio-economic environment.

Summary: This article provides an overview of the screening and selection tools developed over the past 25 years for identifying eligible Parkinson's disease patients for device-aided therapies (DATs). It describes the target therapies, development methods, validation data, and clinical use of the available screening tools. The historical background and potential utility of these tools are also discussed, along with the challenges of development and validation, considering population differences and resource availability.