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  • 1. Johansson, D.
    et al.
    Ericsson, A.
    Johansson, A.
    Medvedev, A.
    Nyholm, D.
    Ohlsson, F.
    Senek, M.
    Spira, J.
    Thomas, Ilias
    Dalarna University, School of Technology and Business Studies, Microdata Analysis.
    Westin, Jerker
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Individualization of levodopa treatment using a microtablet dispenser and ambulatory accelerometry2018In: CNS Neuroscience & Therapeutics, ISSN 1755-5930, E-ISSN 1755-5949, Vol. 24, no 5, p. 439-447Article in journal (Refereed)
    Abstract [en]

    Aim

    This 4‐week open‐label observational study describes the effect of introducing a microtablet dose dispenser and adjusting doses based on objective free‐living motor symptom monitoring in individuals with Parkinson's disease (PD).

    Methods

    Twenty‐eight outpatients with PD on stable levodopa treatment with dose intervals of ≤4 hour had their daytime doses of levodopa replaced with levodopa/carbidopa microtablets, 5/1.25 mg (LC‐5) delivered from a dose dispenser device with programmable reminders. After 2 weeks, doses were adjusted based on ambulatory accelerometry and clinical monitoring.

    Results

    Twenty‐four participants completed the study per protocol. The daily levodopa dose was increased by 15% (112 mg, < 0.001) from period 1 to 2, and the dose interval was reduced by 12% (22 minutes, P = 0.003). The treatment adherence to LC‐5 was high in both periods. The MDS‐UPDRS parts II and III, disease‐specific quality of life (PDQ‐8), wearing‐off symptoms (WOQ‐19), and nonmotor symptoms (NMS Quest) improved after dose titration, but the generic quality‐of‐life measure EQ‐5D‐5L did not. Blinded expert evaluation of accelerometry results demonstrated improvement in 60% of subjects and worsening in 25%.

    Conclusions

    The introduction of a levodopa microtablet dispenser and accelerometry aided dose adjustments improve PD symptoms and quality of life in the short term.

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