Table 5 Symptom domain causing patients most distress: matching status and regression analysis for patient–physician discordance
Between patient and physician | Symptom domain that causes the patient most distress | Univariate LR analysis | Multivariate LR: input significant variables with variable increasing method (likelihood ratio) | |||||
|---|---|---|---|---|---|---|---|---|
Concordance (n = 75) | Discordance (n = 85) | OR | 95% CI | p value | OR | 95% CI | p value | |
Patient-side factors | ||||||||
Patient’s age (y) | n.e. | |||||||
<80.0 | 43 (57.3) | 35 (41.2) | 1.000 | ref | ||||
≥80.0 | 32 (42.7) | 50 (58.8) | 1.920 | 1.023–3.602 | 0.042 | |||
Number of persons living with the patient | ||||||||
Alone | 4 (5.3) | 14 (16.5) | 1.000 | ref | n.e. | |||
Two | 35 (46.7) | 36 (42.4) | 0.294 | 0.088–0.980 | 0.046 | |||
Three or more | 36 (48.0) | 35 (41.2) | 0.278 | 0.083–0.927 | 0.037 | |||
Patient’s initial symptom domain | n.e. | |||||||
Cognitive impairment | 19 (25.7) | 35 (41.2) | 5.066 | 1.895–13.541 | 0.001 | |||
Parkinsonism | 22 (29.7) | 8 (9.4) | 1.000 | ref | ||||
Psychiatric symptoms | 15 (20.3) | 24 (28.2) | 4.400 | 1.563–12.385 | 0.005 | |||
Eating behavior-related problems | 0 (0.0) | 1 (1.2) | n.c. | |||||
Sleep-related disorders | 16 (21.6) | 10 (11.8) | 1.719 | 0.555–5.326 | 0.348 | |||
Autonomic dysfunctions | 2 (2.7) | 3 (3.5) | 4.125 | 0.579–29.392 | 0.157 | |||
Sensory disorders | 0 (0.0) | 4 (4.7) | n.c. | |||||
MDS-UPDRS Part III total score | n.e. | |||||||
<18.0 | 27 (36.0) | 46 (54.8) | 1.000 | ref | ||||
≥18.0 | 48 (64.0) | 38 (45.2) | 0.465 | 0.246–0.879 | 0.019 | |||
MDS-UPDRS Part II total score | n.e. | |||||||
<9.0 | 30 (40.0) | 48 (57.1) | 1.000 | ref | ||||
≥9.0 | 45 (60.0) | 36 (42.9) | 0.500 | 0.266–0.941 | 0.032 | |||
Pharmacotherapy for cognitive impairment | n.e. | |||||||
None | 23 (30.7) | 13 (15.3) | 1.000 | ref | ||||
Yes | 52 (69.3) | 72 (84.7) | 2.450 | 1.137–5.280 | 0.022 | |||
Pharmacotherapy for parkinsonism | n.e. | |||||||
None | 35 (46.7) | 55 (64.7) | 1.000 | ref | ||||
Yes | 40 (53.3) | 30 (35.3) | 0.477 | 0.253–0.901 | 0.023 | |||
Most inconvenient domain that patients selected | ||||||||
Cognitive impairment | 22 (29.3) | 18 (21.2) | 2.318 | 0.937–5.737 | 0.069 | 3.720 | 1.256–11.019 | 0.018 |
Parkinsonism | 34 (45.3) | 12 (14.1) | 1.000 | ref | 1.000 | ref | ||
Psychiatric symptoms | 9 (12.0) | 10 (11.8) | 3.148 | 1.032–9.604 | 0.044 | 5.101 | 1.328–19.601 | 0.018 |
Eating behavior-related problems | 0 (0.0) | 5 (5.9) | n.c. | n.c. | ||||
Sleep-related disorders | 5 (6.7) | 10 (11.8) | 5.667 | 1.609–19.961 | 0.007 | 10.884 | 2.286–51.814 | 0.003 |
Autonomic dysfunction | 5 (6.7) | 30 (35.3) | 17.000 | 5.367–53.851 | <0.001 | 28.533 | 6.419–126.830 | <0.001 |
Sensory disorders | 0 (0.0) | 0 (0.0) | - | - | ||||
Whether the patient told their caregiver or family members about patient’s most inconvenient symptom | n.e. | |||||||
Yes | 63 (91.3) | 64 (78.0) | 1.000 | ref | ||||
No | 4 (5.8) | 16 (19.5) | 3.937 | 1.247–12.430 | 0.019 | |||
Unknown | 2 (2.9) | 2 (2.4) | 0.984 | 0.984–0.134 | 0.988 | |||
Caregiver-side factors | ||||||||
Relationship with the patient from patient’s perspective | n.e. | |||||||
Spouse | 43 (57.3) | 33 (38.8) | 1.000 | ref | ||||
Non-spouse | 32 (42.7) | 52 (61.2) | 2.117 | 1.125–3.984 | 0.020 | |||
Time spent with the patient (h/day) | ||||||||
<16.0 | 27 (36.5) | 49 (59.0) | 2.509 | 1.317–4.779 | 0.005 | 3.679 | 1.538–8.799 | 0.003 |
≥16.0 | 47 (63.5) | 34 (41.0) | 1.000 | ref | 1.000 | ref | ||
Patient’s most inconvenient symptom domain that the caregiver selected | n.e. | |||||||
Cognitive impairment | 19 (31.1) | 18 (24.7) | 1.759 | 0.704–4.394 | 0.226 | |||
Parkinsonism | 26 (42.6) | 14 (19.2) | 1.000 | ref | ||||
Psychiatric symptoms | 8 (13.1) | 11 (15.1) | 2.554 | 0.834–7.816 | 0.100 | |||
Eating behavior-related problems | 0 (0.0) | 3 (4.1) | n.c. | |||||
Sleep-related disorders | 1 (1.6) | 9 (12.3) | 16.714 | 1.917–145.766 | 0.011 | |||
Autonomic dysfunctions | 7 (11.5) | 18 24.7() | 4.776 | 1.608–14.179 | 0.005 | |||
Sensory disorders | 0 (0.0) | 0 (0.0) | - | |||||