Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World Study
Abstract Introduction In advanced Parkinson's disease (aPD), ‘ON-time’ indicates periods of better symptom control, with ‘good ON-time (GOT)’ indicating control without troublesome dyskinesia. Despite its importance, the impact of increased ‘GOT’ on aPD outcomes is understudied. This study aims...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2025-06-01
|
| Series: | Neurology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40120-025-00765-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849738567036698624 |
|---|---|
| author | Joohi Jimenez-Shahed Irene A. Malaty Jean-Philippe Azulay Ashwini Parab Connie H. Yan Prasanna L. Kandukuri Pavnit Kukreja Jorge Zamudio Alexander Gillespie Angelo Antonini |
| author_facet | Joohi Jimenez-Shahed Irene A. Malaty Jean-Philippe Azulay Ashwini Parab Connie H. Yan Prasanna L. Kandukuri Pavnit Kukreja Jorge Zamudio Alexander Gillespie Angelo Antonini |
| author_sort | Joohi Jimenez-Shahed |
| collection | DOAJ |
| description | Abstract Introduction In advanced Parkinson's disease (aPD), ‘ON-time’ indicates periods of better symptom control, with ‘good ON-time (GOT)’ indicating control without troublesome dyskinesia. Despite its importance, the impact of increased ‘GOT’ on aPD outcomes is understudied. This study aims to evaluate the clinical, humanistic, and economic value of incremental hourly increases in ‘GOT’ for people with aPD. Methods The study analyzed data from people with aPD across seven countries, using the Adelphi Parkinson's Disease Specific Program survey (2017–2020). ‘GOT’ (calculated from self-reported ON/OFF-time and the proportion of troublesome dyskinesia time) was normalized to a 16-h day. Outcomes included symptom control, medication use, falls, activities of daily living (ADLs), quality of life (QoL), and healthcare resource utilization (HRU). Regression models evaluated relationships between incremental ‘GOT’ hours and outcomes. Results Of 802 patients (mean [standard deviation; SD] age, 76.1 [8.9] years; male, 60.3%) included in the analysis, mean (SD) ‘GOT’ was 13.1 (2.7) hours/day. Hourly increases in ‘GOT’ were associated with lower likelihood of reporting uncontrolled motor (odds ratio [OR] 0.79; 95% confidence interval (CI) [0.62, 1.01]) and non-motor symptoms (OR 0.88; 95% CI [0.80, 0.96]), taking ≥ 2 PD medication classes (OR 0.91; 95% CI [0.86, 0.97]) and lower fall risk (incidence rate ratio 0.91; 95% CI [0.87, 0.95]). Hourly increases in ‘GOT’ were significantly associated with reduced humanistic burden (greater ADL independence, OR 1.19; 95% CI [1.04 1.37]) and improved QoL (for Parkinson’s Disease Questionnaire [PDQ]-39: coefficient − 1.49; 95% CI [− 2.46, − 0.52]) and with reduced economic burden, with annual total HRU cost-savings of $8602.24 (95% CI − $12,192.70 to $5011.77). Conclusions In this multi-country, real-world study of people with aPD, hourly increases in ‘GOT’ were associated with improved clinical outcomes, greater humanistic value, and reduced economic burden. Interventions that maximize improvement of ‘GOT’ should be considered for people with aPD adequately controlled on current therapy. |
| format | Article |
| id | doaj-art-666758fe030c49bea0f1101dbf16f1d7 |
| institution | DOAJ |
| issn | 2193-8253 2193-6536 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Neurology and Therapy |
| spelling | doaj-art-666758fe030c49bea0f1101dbf16f1d72025-08-20T03:06:31ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362025-06-011441475149310.1007/s40120-025-00765-3Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World StudyJoohi Jimenez-Shahed0Irene A. Malaty1Jean-Philippe Azulay2Ashwini Parab3Connie H. Yan4Prasanna L. Kandukuri5Pavnit Kukreja6Jorge Zamudio7Alexander Gillespie8Angelo Antonini9Department of Neurology, Icahn School of Medicine at Mount SinaiDepartment of Neurology, University of Florida, Fixel Institute for Neurological DiseasesNeurology and Movement Disorders Unit, Expert Centre for Parkinson’s Disease, La Timone HospitalHealth Economics and Outcomes Research, AbbVie Inc.Health Economics and Outcomes Research, AbbVie Inc.Health Economics and Outcomes Research, AbbVie Inc.Health Economics and Outcomes Research, AbbVie Inc.Health Economics and Outcomes Research, AbbVie Inc.Adelphi Real WorldParkinson and Movement Disorders Unit, Center for Neurodegenerative Diseases CESNE, Department of Neuroscience, University of PadovaAbstract Introduction In advanced Parkinson's disease (aPD), ‘ON-time’ indicates periods of better symptom control, with ‘good ON-time (GOT)’ indicating control without troublesome dyskinesia. Despite its importance, the impact of increased ‘GOT’ on aPD outcomes is understudied. This study aims to evaluate the clinical, humanistic, and economic value of incremental hourly increases in ‘GOT’ for people with aPD. Methods The study analyzed data from people with aPD across seven countries, using the Adelphi Parkinson's Disease Specific Program survey (2017–2020). ‘GOT’ (calculated from self-reported ON/OFF-time and the proportion of troublesome dyskinesia time) was normalized to a 16-h day. Outcomes included symptom control, medication use, falls, activities of daily living (ADLs), quality of life (QoL), and healthcare resource utilization (HRU). Regression models evaluated relationships between incremental ‘GOT’ hours and outcomes. Results Of 802 patients (mean [standard deviation; SD] age, 76.1 [8.9] years; male, 60.3%) included in the analysis, mean (SD) ‘GOT’ was 13.1 (2.7) hours/day. Hourly increases in ‘GOT’ were associated with lower likelihood of reporting uncontrolled motor (odds ratio [OR] 0.79; 95% confidence interval (CI) [0.62, 1.01]) and non-motor symptoms (OR 0.88; 95% CI [0.80, 0.96]), taking ≥ 2 PD medication classes (OR 0.91; 95% CI [0.86, 0.97]) and lower fall risk (incidence rate ratio 0.91; 95% CI [0.87, 0.95]). Hourly increases in ‘GOT’ were significantly associated with reduced humanistic burden (greater ADL independence, OR 1.19; 95% CI [1.04 1.37]) and improved QoL (for Parkinson’s Disease Questionnaire [PDQ]-39: coefficient − 1.49; 95% CI [− 2.46, − 0.52]) and with reduced economic burden, with annual total HRU cost-savings of $8602.24 (95% CI − $12,192.70 to $5011.77). Conclusions In this multi-country, real-world study of people with aPD, hourly increases in ‘GOT’ were associated with improved clinical outcomes, greater humanistic value, and reduced economic burden. Interventions that maximize improvement of ‘GOT’ should be considered for people with aPD adequately controlled on current therapy.https://doi.org/10.1007/s40120-025-00765-3Advanced Parkinson’s diseaseClinicalEconomicHumanisticON-timeTroublesome dyskinesia |
| spellingShingle | Joohi Jimenez-Shahed Irene A. Malaty Jean-Philippe Azulay Ashwini Parab Connie H. Yan Prasanna L. Kandukuri Pavnit Kukreja Jorge Zamudio Alexander Gillespie Angelo Antonini Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World Study Neurology and Therapy Advanced Parkinson’s disease Clinical Economic Humanistic ON-time Troublesome dyskinesia |
| title | Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World Study |
| title_full | Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World Study |
| title_fullStr | Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World Study |
| title_full_unstemmed | Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World Study |
| title_short | Clinical, Humanistic, and Economic Value of ‘Good ON-Time’ in Advanced Parkinson’s Disease: A Multinational Real-World Study |
| title_sort | clinical humanistic and economic value of good on time in advanced parkinson s disease a multinational real world study |
| topic | Advanced Parkinson’s disease Clinical Economic Humanistic ON-time Troublesome dyskinesia |
| url | https://doi.org/10.1007/s40120-025-00765-3 |
| work_keys_str_mv | AT joohijimenezshahed clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT ireneamalaty clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT jeanphilippeazulay clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT ashwiniparab clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT conniehyan clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT prasannalkandukuri clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT pavnitkukreja clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT jorgezamudio clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT alexandergillespie clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy AT angeloantonini clinicalhumanisticandeconomicvalueofgoodontimeinadvancedparkinsonsdiseaseamultinationalrealworldstudy |