Expert Consensus on the Use of On‐Demand Treatments for OFF Episodes in Parkinson's Disease: A Modified Delphi Panel

On-demand treatments can treat OFF episodes in Parkinson's disease, however, there is limited information regarding when to prescribe them.Develop expert consensus to determine appropriate clinical factors for considering on-demand treatments.Using a RAND/UCLA modified Delphi panel method, a panel developed consensus on the use of on-demand treatments for OFF episodes.The panel agreed on-demand treatments were appropriate when OFF episodes were associated with greater functional impact and interfered with basic daily activities. The panel also agreed on-demand treatment may be appropriate for patients with morning akinesia and/or delayed ON of first levodopa dose and >1 type of OFF episode (eg, early morning OFF or wearing OFF regardless of frequency).Experts agreed on-demand treatment is appropriate for many patients with OFF episodes. The greater the functional impact of OFF episodes, the more likely experts agreed that on-demand treatment is appropriate to prescribe.