Opinion|Videos|April 30, 2025

Conversations About Off Time In Patients With Parkinson Disease

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

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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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