Opinion|Videos|April 30, 2025

Conversations About Off Time In Patients With Parkinson Disease

Author(s)Stuart H. Isaacson, MD, FAAN
Daniel E. Kremens, MD, JD

Panelists discuss how physicians approach conversations about off time with patients with Parkinson disease, balancing clinical assessment with patient education and shared decision-making.

Video content above is prompted by the following:

Physician-Patient Communication About Off Time

Structured assessment using validated tools (Movement Disorder Society (MDS), Unified Parkinson's Disease Rating (UPDRS), Wearing Off Questionnaire-9 (WOQ-9), Hauser Diary)
Dedicated time to discuss daily symptom patterns and medication response
Use of accessible language and visual aids to explain pharmacokinetics
Involvement of caregivers to provide collateral information
Setting realistic expectations about treatment goals
Shared decision-making approach to treatment selection
Regular follow-up with focused reassessment of off time
Discussion of impact on quality of life and function, not just motor symptoms
Education about differentiating off symptoms from nonmotor manifestations

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