EFFICACY OF A PATIENT-TRAINING VIDEOTAPE ON MOTOR FLUCTUATIONS FOR ON-OFF DIARIES IN PARKINSONS-DISEASE

Patient on-off diaries are used in clinical trials, but a method to as sure agreement between patient and examiner has never been developed. We tested whether a patient-teaching tape increased the rate of agreem ent between patient diary ratings and simultaneous neurologic assessme nt by a trained professional. A total of 32 consecutive patients who h ad Parkinson's disease with motor fluctuations independently completed a 4-h on-off diary (nine ratings) at the same time as an examiner. Th ose with <80% agreement with the examiner (n = 20) were randomized to view either a training tape that showed motor fluctuations (experiment al group) or another videotape of general patient educational material (control group). All patients then underwent the same 4-h assessment of motor fluctuations. To test for long-term retention, they returned 1 month later and, without reviewing the videotape, underwent a final 4-h correlation assessment. After the training tape, the experimental group showed significant improvement, whereas the control group showed no improvement. Furthermore, another month later, the improvement in the experimental group was retained. Based on these findings, we sugge st that future clinical trials assessing motor fluctuations incorporat e this tape into their basic methodology.