Wearing-off detection in clinical practice: The wearing off real practice key (WORK-PD) study in Parkinson's disease

• WORK-PD study confirms the WOQ-19 can identify WO in the “real world”.
• The WOQ 19 questionnaire is easily administered and suitable for routine outpatient use.
• It could be useful in the early identification of non-motor symptoms.
• The WOQ 19 administration is only slightly time-consuming.

ObjectiveVerifying the validity and feasibility of the WOQ-19 as a useful tool in routine clinical practice and in management of patients.Methods532 consecutive Parkinson's disease (PD) patients were recruited from 6 different neurological outpatient units, specialized in movement disorders, of central Italy. Inclusion criteria were diagnosis of PD and any current pharmacological treatment of PD while exclusion criteria were evident cognitive or depressive impairment, infusion with dopamine agonists or Duodopa, or Deep Brain Stimulation therapy. Patients were asked to complete the Italian version of WOQ-19 before the neurological visit. A medical form for the collection of demographic and clinical data of patients and for the evaluation of comprehensibility and usability the WOQ-19 was filled by the neurologist during the visit.ResultsOur data confirmed that WOQ-19 was able to identify WO in 69% of patients, a percentage similar to the recently reported in the Italian WOQ-19 validation study. Motor symptoms were more frequent than non-motor symptoms (80% vs. 20%). Patients who experienced WO had a higher age of PD onset, more severe disease, longer disease duration and were more likely to be female.ConclusionsThe WOQ-19 was understandable for the patient, easily administered and suitable for routine outpatient use. It could be also particularly useful in clinical practice in the early identification of non-motor symptoms, often under reported by patients and revealed only with clinical support.