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  • Patient Satisfaction in Surgery for Parkinson’s Disease: A Systematic Review of the Literature

    Final Number:

    Joshua York Menendez MD; Harrison Walker MD; Beverly C. Walters MD, MSc, FRCS(C), FACS; Barton L. Guthrie MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Patient satisfaction is a measurement reflecting patients’ perception of outcome of care and has been considered for use in future reimbursement schemes. An ideal patient satisfaction instrument could guide changes in surgical practice for quality improvement. Currently, no consensus on patient satisfaction instruments exists in the medical or surgical treatment of Parkinson’s disease (PD). Use of quality of life instruments such as the Parkinson’s Disease Questionnaire is widespread, but this does an inadequate job of measuring patient satisfaction. The goals of this review are to establish how patient satisfaction with surgical treatment of PD has been previously measured, determine if an ideal patient satisfaction instrument exists, and to define the dimensions of care that determine patient satisfaction with the surgical treatment of PD.

    Methods: A systematic search of four online databases, unpublished sources, and citations was undertaken to identify 15 studies reporting patient satisfaction with the surgical treatment of PD. Manuscripts were reviewed and instruments were categorized by content and method axes. Major factors influencing patient satisfaction were identified and acted as a structure to define the dimensions of patient satisfaction in the surgical treatment of PD.

    Results: Studies used predominantly multidimensional (10/16), rather than global (6/16) satisfaction instruments. Generic (12/16) rather than disease specific (4/16) instruments were utilized more frequently. Every study reported on satisfaction with outcome and four studies reported on satisfaction with outcome and care. Six dimensions of patient status, outcome and care experience affecting patient satisfaction were identified: motor function, patient-specific health characteristics, programming/long-term care, surgical considerations, device/hardware, and functional independence.

    Conclusions: At present, no patient satisfaction instrument exists that is disease- specific and covers all dimensions of patient satisfaction in surgery for PD. For quality improvement, such a disease-specific, comprehensive patient satisfaction instrument should be designed, validated, and implemented.

    Patient Care: Development of a comprehensive satisfaction instrument for this population will give a new clinical outcome measure for future studies.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the axes of patient satisfaction 2) Understand the current state of the measurement of patient satisfaction in the surgical treatment of Parkinson's disease 3) Discuss the factors that drive satisfaction in this patient population

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