Early-stage Parkinson’s Disease Experiences with a Week-long Dopaminergic Medication Washout
Kian Pazira1, Liliana Venditti1, Kemberlee Bonnet2, David Schlundt2, David Charles1, Mallory Hacker1
1Vanderbilt University Medical Center, 2Vanderbilt University
Objective:
To describe early-stage Parkinson’s disease (PD) experiences when completing a one-week washout of dopaminergic medications.
Background:
Dopaminergic medications are the mainstay for treating PD, but their symptomatic efficacy inherently masks measuring the underlying progression of the disease. While evaluating an extended treatment-withdrawn state can provide valuable insights into PD, discontinuing medications can be challenging for study participants. Gaining a deeper understanding of what is experienced during an extended medication washout is essential for informing future clinical trial designs.
Design/Methods:
Eleven early-stage PD participants completed a one-week dopaminergic medication washout study. After the washout, participants completed a semi-structured interview to capture their experiences with the study procedures. Interviews were audio-recorded and transcribed. A hierarchical coding system was developed and refined using the interview guide and preliminary review of the transcripts.
Results:
Early-stage PD participants (9/11 male) were aged 63.8±6.7 years (mean±SD) with a medication duration of 1.6±0.7 years. The iterative process of developing the coding system allowed preliminary themes to be identified. Nearly half of participants (5/11) reported being surprised at how well they managed without their medications, describing the washout as “less challenging” and “less stressful” than anticipated. Four noted that it took 5-6 days for symptoms to noticeably worsen. One described the experience as “a little foreshadowing,” expressing that being off medications provided a glimpse into a possible future where the progression of the disease may render such symptom control difficult.
Conclusions:
Many early-stage PD participants found the one-week washout experience less stressful or challenging than expected. By contrast, one participant reflected on a study-induced awareness of what their disease progression might look like. These findings highlight the significance of understanding participant perspectives when considering research procedures. By understanding and addressing challenges participants encounter, investigators can enhance the conduct of future trials in people with early-stage Parkinson’s disease.
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