Priority setting partnership to identify the top 10 research priorities for the management of Parkinson's disease

Objectives This priority setting partnership was commissioned by Parkinson's UK to encourage people with direct and personal experience of the condition to work together to identify and prioritise the top 10 evidential uncertainties that impact on everyday clinical practice for the management of Parkinson's disease (PD). Setting The UK. Participants Anyone with experience of PD including: people with Parkinson's (PwP), carers, family and friends, healthcare and social care professionals. Non-clinical researchers and employees of pharmaceutical or medical devices companies were excluded. 1000 participants (60% PwP) provided ideas on research uncertainties, 475 (72% PwP) initially prioritised them and 27 (37% PwP) stakeholders agreed a final top 10. Methods Using a modified nominal group technique, participants were surveyed to identify what issues for the management of PD needed research. Unique research questions unanswered by current evidence were identified and participants were asked to identify their top 10 research priorities from this list. The top 26 uncertainties were presented to a consensus meeting with key stakeholders to agree the top 10 research priorities. Results 1000 participants provided 4100 responses, which contained 94 unique unanswered research questions that were initially prioritised by 475 participants. A consensus meeting with 27 stakeholders agreed the top 10 research priorities. The overarching research aspiration was an effective cure for PD. The top 10 research priorities for PD management included the need to address motor symptoms (balance and falls, and fine motor control), non-motor symptoms (sleep and urinary dysfunction), mental health issues (stress and anxiety, dementia and mild cognitive impairments), side effects of medications (dyskinesia) and the need to develop interventions specific to the phenotypes of PD and better monitoring methods. Conclusions These research priorities identify crucial gaps in the existing evidence to address everyday practicalities in the management of the complexities of PD.

[1]  Bill Bynum,et al.  Lancet , 2015, The Lancet.

[2]  PD Med Collaborative Group Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial , 2014, The Lancet.

[3]  A. Gray,et al.  Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial. , 2014, Lancet.

[4]  T. Abma,et al.  Living with Parkinson's disease: priorities for research suggested by patients. , 2014, Parkinsonism & related disorders.

[5]  P. Myint,et al.  Adherence therapy improves medication adherence and quality of life in people with Parkinson's disease: a randomised controlled trial , 2014, International journal of clinical practice.

[6]  Hannah Cook Parkinson's disease society. , 2013, Nursing older people.

[7]  B. Bloem,et al.  The impact of occupational therapy in Parkinson’s disease: a randomized controlled feasibility study , 2013, Clinical rehabilitation.

[8]  P. Myint,et al.  Systematic review on factors associated with medication non-adherence in Parkinson's disease. , 2012, Parkinsonism & related disorders.

[9]  M. Brady,et al.  Comparison of speech and language therapy techniques for speech problems in Parkinson's disease. , 2012, The Cochrane database of systematic reviews.

[10]  Carl E Clarke,et al.  Speech and language therapy versus placebo or no intervention for speech problems in Parkinson's disease. , 2012, The Cochrane database of systematic reviews.

[11]  Catherine Sackley,et al.  Physiotherapy intervention in Parkinson’s disease: systematic review and meta-analysis , 2012, BMJ : British Medical Journal.

[12]  Catherine Sherrington,et al.  Balance and falls in Parkinson's disease: A meta‐analysis of the effect of exercise and motor training , 2011, Movement disorders : official journal of the Movement Disorder Society.

[13]  C. Clarke,et al.  Meta‐analysis of the comparative efficacy and safety of adjuvant treatment to levodopa in later Parkinson's disease , 2011, Movement disorders : official journal of the Movement Disorder Society.

[14]  C. Counsell,et al.  Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease. , 2009, The Cochrane database of systematic reviews.

[15]  A. Grant,et al.  Prioritizing research: Patients, carers, and clinicians working together to identify and prioritize important clinical uncertainties in urinary incontinence , 2009, Neurourology and urodynamics.

[16]  R. Hughes The NHS Constitution , 2009 .

[17]  I. Chalmers Confronting therapeutic ignorance , 2008, BMJ : British Medical Journal.

[18]  H. Thornton Patient and public involvement in clinical trials , 2008, BMJ : British Medical Journal.

[19]  J. Ferreira,et al.  Dopamine agonist therapy in early Parkinson's disease. , 2008, The Cochrane database of systematic reviews.

[20]  C. Ramaker,et al.  Bromocriptine/levodopa combined versus levodopa alone for early Parkinson's disease. , 2007, The Cochrane database of systematic reviews.

[21]  Ann Ashburn,et al.  A meta‐analysis of six prospective studies of falling in Parkinson's disease , 2007, Movement disorders : official journal of the Movement Disorder Society.

[22]  K. Dashtipour,et al.  Comprehensive review of rasagiline, a second-generation monoamine oxidase inhibitor, for the treatment of Parkinson's disease. , 2007, Clinical therapeutics.

[23]  H. Taylor,et al.  Occupational therapy for patients with Parkinson's disease. , 2007, The Cochrane database of systematic reviews.

[24]  B. Delaney Is society losing control of the medical research agenda? , 2006, BMJ : British Medical Journal.

[25]  J. Ioannidis,et al.  Origin and funding of the most frequently cited papers in medicine: database analysis , 2006, BMJ : British Medical Journal.

[26]  J. Scadding,et al.  The James Lind Alliance: patients and clinicians should jointly identify their priorities for clinical trials , 2004, The Lancet.

[27]  C. Clarke,et al.  Catechol-O-methyltransferase inhibitors versus active comparators for levodopa-induced complications in Parkinson's disease. , 2004, The Cochrane database of systematic reviews.

[28]  J. Kemm Well informed uncertainties about the effects of treatment , 2004, BMJ : British Medical Journal.

[29]  Iain Chalmers,et al.  Well informed uncertainties about the effects of treatments , 2004, BMJ : British Medical Journal.

[30]  A. Lees,et al.  Anticholinergics for symptomatic management of Parkinson's disease. , 2002, The Cochrane database of systematic reviews.

[31]  Paul Dieppe,et al.  Relation between agendas of the research community and the research consumer , 2000, The Lancet.

[32]  R. Cumming,et al.  Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[33]  M. Baker The Parkinson's Disease Society. , 1988, Geriatric nursing and home care.

[34]  J. B. Gregg,et al.  DEPARTMENT OF HEALTH. , 1910, California state journal of medicine.