Background: There has been a new emphasis on the use of health related quality of life (HRQOL) measures for translating how a patient's response to treatment is experienced by the patient. The purpose of this study was to describe patient reported HRQOL two years after surgery in subjects who underwent posteroventral pallidotomy (PVP) for the treatment of Parkinson's disease (PD) and a subset of these same subjects four years following PVP.
Method: A consecutive series of 52 subjects who were evaluated previously, prior to and at 4 months following PVP [3], received long term follow-up using mailed questionnaires. Twenty seven subjects (52% of the original sample) provided 2 year follow-up data and 15 of these subjects (29%) provided 4 year follow-up data. Severity of disease and subject reported HRQOL were evaluated.
Findings: Immediately following surgery, there was a sharp decrease in all measures of severity of disease. While there were differing patterns of increasing severity of disease among the measures following the immediate postoperative assessment, all of the measures remained better than the pre-surgery values. The data showed a pattern of marked improvement in HRQOL at 4 months following PVP. Over the 2 years following surgery, there was a gradual deterioration toward preoperative levels that nevertheless remained better than preoperative HRQOL. For the group with data at 4 years following surgery, there was no significant further deterioration in HRQOL between 2 and 4 years, with the 4 year data also remaining better than the preoperative HRQOL reports.
Conclusions: In spite of advanced severe PD and advanced age, subjects in this study reported better HRQOL at 2 years following PVP than they reported at entry into the study prior to surgery. Additionally, the 15 patients who were available for follow-up at 4 years also reported better HRQOL than they experienced prior to the surgery.