Interest of Continuous Subcutaneous Apomorphine in Parkinsonian Patients at the End of Life
OPTIDOM
1 other identifier
observational
80
1 country
1
Brief Summary
Care for Parkinson's patients at the end of life is far from optimal, particularly due to specificities linked to the disease itself, often unknown to non-specialists. A study carried out at the CHU Rennes on data covering the period 2006-2018 showed that only 132 patients died in this hospital, two-thirds of whom came from home. In 42% of cases, antiparkinsonian treatment was stopped before death without specialist advice (palliative or neurological), with the corollary of the appearance of a dopaminergic withdrawal syndrome (or pseudo-neuroleptic malignant syndrome) in a high proportion of these patients. Neuroleptic pseudo-malignant syndrome is a major cause of discomfort. If left untreated, it can precipitate death in particularly distressing conditions for the patient, his or her family and caregivers. The Rennes study also suggests that Parkinson's patients rarely die in hospital. In fact, work carried out by FNEHAD on data for 2022 showed that 1,800 Parkinson's patients were cared for in HAH in France during that same year, mainly for palliative care or heavy nursing reasons. Half of these patients died. End-of-life management of Parkinson's disease therefore requires local clinical and pharmacological expertise. A recent observational study suggests that the use of a subcutaneous apomorphine pump brings substantial benefits in terms of clinical comfort, both motor and non-motor, as well as relief for family and friends, easier nursing care for the nursing team, and in some cases, renewed communication. Such care can be provided in the home, and must necessarily be multidisciplinary, combining palliative expertise, provided by Home Hospitalization (HH) teams, with technical and Parkinson's expertise, provided by Home Healthcare Providers (HHPs) experienced in managing the apomorphine pump, in liaison with the referral team.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for all trials
Started Feb 2026
Shorter than P25 for all trials
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
September 18, 2025
CompletedFirst Posted
Study publicly available on registry
December 2, 2025
CompletedStudy Start
First participant enrolled
February 2, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 1, 2027
ExpectedStudy Completion
Last participant's last visit for all outcomes
February 1, 2027
March 23, 2026
March 1, 2026
12 months
September 18, 2025
March 19, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
Rigidity
measured by the specific sub-section of rigidity of the internationally recognized UPDRS 3 scale validated in French. This criterion will be assessed before the apomorphine pump is installed and 6 days afterwards. The 5 items are scored from 0 to 4, so the total score ranges from 0 to 20.
Day 0
Rigidity
measured by the specific sub-section of rigidity of the internationally recognized UPDRS 3 scale validated in French. This criterion will be assessed before the apomorphine pump is installed and 6 days afterwards. The 5 items are scored from 0 to 4, so the total score ranges from 0 to 20.
Day 6
Secondary Outcomes (9)
Change in analgesic consumption
Day 45
Change in alertness and agitation levels
Day 45
Change in communication with the care team and relatives
Day 45
Change in nursing care
Day 45
Change in caregiver burden
Day 0, 2, 6, 18, 30 and Day 45
- +4 more secondary outcomes
Study Arms (1)
Parkinson patients
Parkinsonian patients in HH will receive an apomorphine pump as part of their routine care. Questionnaires will be completed at D0, D2, D4, D6, D12, D18, D24, D30 and D45. The questionnaires used will be * UPDSR III: rigidity * Algoplus * Richmond Scale (RASS) * Likert scale Entourage before/after * Likert scale Caregivers before/after * Zarit scale
Interventions
Parkinsonian patients in HH will receive an apomorphine pump as part of their routine care. Questionnaires will be completed at D0, D2, D4, D6, D12, D18, D24, D30 and D45. The questionnaires used will be * UPDSR III: stiffness * Algoplus * Richmond Scale (RASS) * Likert scale Entourage before/after * Likert scale Caregivers before/after * Zarit scale
Eligibility Criteria
Parkinsonian patients treated in HH.
You may qualify if:
- Person (or trusted person/relative if patient is unable) who has agreed to participate in the study
- Patient of legal age
- Advanced Parkinson's disease with apomorphine pump indication
- Use of HH for palliative reasons
- Loss of orality (discontinuation of oral treatments)
- Hoehn \&Yahr score in OFF = 5 (bilateral and axial symptoms in the absence of levodopa)
You may not qualify if:
- Apomorphine pump already in use
- Opposition to the introduction of an apomorphine pump
- Protected person (under guardianship or curatorship)
- Person under court protection
- Persons deprived of liberty
- Persons not affiliated to a social security scheme
- Pregnant or breast-feeding woman
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Had Crest
Crest, France
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
September 18, 2025
First Posted
December 2, 2025
Study Start
February 2, 2026
Primary Completion (Estimated)
February 1, 2027
Study Completion (Estimated)
February 1, 2027
Last Updated
March 23, 2026
Record last verified: 2026-03