Advanced-Stage Parkinson's Disease: From Identification to Characterization Using a Nationwide Database.
Parkinson's disease
antiparkinson agents
cost of illness
dyskinesias
levodopa
Journal
Movement disorders clinical practice
ISSN: 2330-1619
Titre abrégé: Mov Disord Clin Pract
Pays: United States
ID NLM: 101630279
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
18
11
2021
revised:
13
02
2022
accepted:
05
04
2022
entrez:
19
5
2022
pubmed:
20
5
2022
medline:
20
5
2022
Statut:
epublish
Résumé
As Parkinson's disease (PD) progresses, response to oral medications decreases and motor complications appear. Timely intervention has been demonstrated as effective in reducing symptoms. However, current instruments for the identification of these patients are often complicated and inadequate. It has been suggested that anti-PD intensified therapy (IT) can serve as a proxy for increased burden of disease. To explore whether IT aligns with events reflecting advanced PD (APD) burden. This was a retrospective analysis of PD beneficiaries in the second-largest healthcare provider in Israel. Patients with PD diagnosed between January 2000 and June 2018 and treated with levodopa (l-dopa) ≥5 times/day and/or ≥1000 mg l-dopa equivalent daily dose were defined as the IT cohort (n = 2037). Treated patients with PD not fulfilling this criterion were defined as the nonintensified therapy (NIT) cohort (n = 3402). Point prevalence and 5- and 10-year cumulative incidence of IT were assessed. Baseline demographic and comorbidities, 1-year healthcare resource use, health costs, and time to clinical events were assessed and compared between cohorts. IT was associated with significantly ( Treatment intensity can serve as an objective and robust indicator of more APD. This readily extractable marker can be easily integrated into electronic medical record alerts to actively target more advanced patients and to guide risk-appropriate care.
Sections du résumé
Background
UNASSIGNED
As Parkinson's disease (PD) progresses, response to oral medications decreases and motor complications appear. Timely intervention has been demonstrated as effective in reducing symptoms. However, current instruments for the identification of these patients are often complicated and inadequate. It has been suggested that anti-PD intensified therapy (IT) can serve as a proxy for increased burden of disease.
Objective
UNASSIGNED
To explore whether IT aligns with events reflecting advanced PD (APD) burden.
Methods
UNASSIGNED
This was a retrospective analysis of PD beneficiaries in the second-largest healthcare provider in Israel. Patients with PD diagnosed between January 2000 and June 2018 and treated with levodopa (l-dopa) ≥5 times/day and/or ≥1000 mg l-dopa equivalent daily dose were defined as the IT cohort (n = 2037). Treated patients with PD not fulfilling this criterion were defined as the nonintensified therapy (NIT) cohort (n = 3402). Point prevalence and 5- and 10-year cumulative incidence of IT were assessed. Baseline demographic and comorbidities, 1-year healthcare resource use, health costs, and time to clinical events were assessed and compared between cohorts.
Results
UNASSIGNED
IT was associated with significantly (
Conclusions
UNASSIGNED
Treatment intensity can serve as an objective and robust indicator of more APD. This readily extractable marker can be easily integrated into electronic medical record alerts to actively target more advanced patients and to guide risk-appropriate care.
Identifiants
pubmed: 35586537
doi: 10.1002/mdc3.13458
pii: MDC313458
pmc: PMC9092754
doi:
Types de publication
Journal Article
Langues
eng
Pagination
458-467Informations de copyright
© 2022 International Parkinson and Movement Disorder Society.
Déclaration de conflit d'intérêts
The study was funded by AbbVie. The design and study conduct were performed in collaboration of AbbVie with Maccabi healthcare services as well as participation of the interpretation of data, review, and approval of the publication. No honoraria or payments were made for authorship. Y.B., G.C., and V.S. have no conflict of interest.
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