Symptom Control of Parkinson Disease Linked to Ability, Productivity of Employment

Study results presented at AMCP Nexus 2019 in National Harbor, Maryland, showed that 65.4% of patients with parkinson disease (PD) reported experiencing symptom recurrence, known as OFF periods, which impedes work productivity and employment.

ON periods for patients with PD (PwP) are when symptoms are controlled, but during OFF periods, these symptoms can cause a significant impact on quality of life and financial stability of PwP and caregivers. These OFF periods are shown to occur in 40% of patients after 4-6 years of treatment, and in 90% after 10 years.

To examine the financial burden of PD, researchers part of the Michael J. Fox Foundation (MJFF) and the Parkinson Foundation conducted the “Financial and Social Impact of Parkinson’s Disease Survey,” which collected data gathered by MJFF from September 17 to October 8, 2018. Researchers sought to determine the impact of OFF periods on aspects of employment for PwPs through comparing patients who have OFF periods compared to those who do not:

• Survey included a respondent population of 4548
• One survey per PwP completed online voluntarily by either the PwP, unpaid care partner, family member, or close friend of the PwP
• Data of participants who reported OFF periods within the PwP in the past 12 months were compared to data from those who did not experience OFF periods

Survey respondents consisted of 3098 (68.1%) PwP, 1264 (27.8%) unpaid care partners, 180 (4.0%) family members, and 6 (0.1%) close friends of the PwP. In the study results, 65.4% (n = 2976) of PwP were reported as having OFF periods, with 26.5% (n = 1204) without OFF periods and 8.1% (n = 368) reporting no response or not knowing status.

Full-time or part-time employment status was similar in both PwP with reported OFF periods versus those who did not, with a slight decrease in those with (OFF employment = 19%; non-OFF employment = 22.2%). Additionally, starkly more caregivers for PwPs with OFF periods were employed (42.2%) compared to caregivers for those without OFF periods (33.2%).

In 56.3% of PwP with OFF periods, respondents reported that symptom recurrence played a major role in the PwP decision to stop working, significantly more than PwP without OFF periods (30.9%). This trend was also found in caregivers for PwPs with OFF periods, as they were more likely to stop working due to PD compared to those without OFF periods (29.0% versus 17.3%). Work productivity for PwP with OFF periods suffered as well, as a greater proportion of those with as opposed to those without OFF periods missed workdays and had less-productive workdays per month:

• 17.5% of PwPs with OFF periods missed at least 10 days per month versus 9.5% of those without OFF periods — 10 days is approximately half of a typical work month of 23 days
• 51.7% of PwPs with OFF periods averaged at least 10 less-productive workdays per month versus 35.2% of PwPs without OFF periods
• 31.9% of PwPs with OFF periods averaged at least 20 days per month with low productivity

The significance of OFF periods for PwP and caregivers in deciding whether to work reveals a growing trend attributed to the impact of symptom recurrence on the ability to work and productivity when working. Researchers noted that better management of OFF symptoms within PwP can assist in maintaining employment and improving work productivity for this population.

Reference

Abeynayake I, Marinucci LN, Klingler M, et al. Impact of OFF Periods on Aspects of Employment for People With Parkinson’s Disease. Presented at AMCP Nexus, National Harbor, Maryland; October 29 to November 1, 2019. Abstract: P9285.