Reports from the field-Disease Management

Drug controls Parkinson's, lowers dyskinesia risk

A recent study presented at the 13th Interna tional Congress on Parkinson's disease in Vancouver shows that ropinirole hydrochloride successfully manages Parkinson's disease and significantly lowers the risk of developing dyskinesia, or involuntary body movements that often are associated with other Parkinson's therapies.

Researchers randomized a sample of 268 Parkinson's patients to receive with ropinirole hydrochloride or levodopa and evaluated them over a five-year period. The double-blind, parallel-group study evaluated the incidence of dyskinesia. Patients in both groups whose symptoms were not improved were given supplemental levodopa.

Of those enrolled, 130 patients completed the five-year study with 85 in the ropinirole hydrochloride group and 45 in the levodopa group. Findings include:

• 64% of patients in the levodopa group and 34% of patients in the ropinirole hydrochloride group completed the five-year study without supplemental levodopa.

• The incidence of dyskinesia was 5% in the ropinirole hydrochloride group and 36% in the levodopa group.

• Of patients receiving supplemental levodopa, 20% of the ropinirole hydrochloride group with supplemental levodopa developed dyskinesia, compared with 46% of levodopa patients receiving supplemental levodopa.

Asthma patients prefer emergency room to hospital

Patients admitted to the emergency room (ER) suffering from an acute asthma episode are more satisfied with their care if they remain for 12 hours in an emergency room-based observation unit than if they are admitted to the hospital, a study says.

Researchers studied 163 asthma patients admitted to the ER over a 30-month period who met the criteria for hospital admission after three hours of ER asthma therapy. They randomly selected 81 patients to receive care in an ER-based observation unit and 82 patients to routine hospital admission.

Patients in the observation unit group scored higher after diagnosis and treatment than those in the inpatient group on seven care satisfaction measures.

The dividing line

The observation unit group scored significantly higher than the inpatient group on these four measures:

• received services desired;

• would recommend the service to others;

• were satisfied with service;

• were satisfied overall with care.

In addition, the observation unit group reported fewer total problems with care and fewer problems with communication, emotional support, physical comfort, and special needs than inpatients.

[See: Rydman RJ, Roberts RR, Albrecht GL, et al. Patient satisfaction with an emergency department asthma observation unit. Acad Emerg Med 1999; 6:178-183.]