Association of OFF period characteristics with patient communication behaviors in Parkinson's disease.

Abstract

Objective: Underreporting of OFF symptoms and poor patient-provider communication are known challenges in Parkinson's disease (PD). We aimed to determine: (a) OFF period patient communication behavior components and (b) whether OFF period characteristics (frequency, duration, severity) were associated with communication behaviors.

Methods: A retrospective cohort study using the Fox Insight database was conducted. OFF periods were characterized by frequency (number of episodes/day), duration (duration/episode), and severity (impact on activities). The "Impact and Communication about OFF periods" questionnaire data were subjected to principal components analysis. Generalized linear model regressions with log link function were used to identify associations with OFF period characteristics.

Results: Data from 526 respondents showed that 89% were non-Hispanic whites, mean age = 65 ± 8.9 years, with PD duration = 6 ± 4.8 years. The majority (67%) had a frequency of 1-2 OFF periods/day, with the highest percent (31.4%) having 15-30 min OFF periods duration, and majority (63%) having none-to-some OFF periods severity. Two component communication behaviors were identified: (1) reluctance communicating (7 items, Cronbach's alpha (CA) = 0.851) and difficulty communicating (4 items, CA = 0.857). Above-average OFF periods severity was associated with a 12% higher reluctance score (beta = 0.117, 95% confidence interval (CI) = 0.03-0.21, p = 0.024). Higher OFF periods frequency and above-average severity were associated with greater difficulty communicating (Frequency: beta = 0.125, 95% CI = 0.03-0.22, p = 0.024; Severity: (beta = 0.186, 95% CI = 0.08-0.29, p = 0.003)) about OFF periods.

Conclusion: Patient communication about OFF periods involves two main factors: their difficulty and reluctance to communicate. Greater frequency and severity of OFF periods were associated with greater difficulty and reluctance to communicate. Understanding these relationships can guide providers to take preemptive efforts to promote OFF periods communication, enhancing care quality.