Quantifying the Tolerability of Dopamine Agonist Antiparkinsonian Medication Side Effects: A Best-Worst Scaling Survey

Purpose: To identify dopamine agonist (DA) medication side effects that people with Parkinson's (PwP) disease view as most and least tolerable and how this impacts their decisions to initiate and remain on treatment. Patients and Methods: An online survey was conducted with PwP and care partner proxies for patients with more advanced Parkinson's disease (PD) who were recruited from Michael J. Fox Foundation patient networks and online PD community. The survey contained a best-worst scaling (BWS) component to assess patient tolerability of 10 DA medication side effects identified through literature and qualitative research. Descriptive and statistical analyses were conducted to address the study objectives. Results: According to the 102 survey respondents, the three least tolerable side effects were sudden/overwhelming sleepiness, hallucinations, and compulsive behaviors. Lightheadedness, headache, and nausea were the three most tolerable side effects. Results were similar between those who were diagnosed ≤5 years and >5 years prior. The least tolerable side effects were associated with an unwillingness to start or continue taking DA medications. Conclusion: Findings demonstrate that patients' tolerance of potential adverse effects can potentially impact treatment initiation and continuation. Thus, healthcare providers for PwP should discuss medication side effect profiles with their patients prior to treatment initiation and as medication therapy is reviewed and evaluated to promote treatment adherence and positive health outcomes.