Abstract
BackgroundParkinson's disease (PD) is a chronic neurodegenerative disease which at present has no cure, and it usually results in severe disability. The burden of PD increases as the illness progresses, resulting in the extensive utilisation of both health and community services. Knowledge of healthcare use patterns and of their determinants may greatly contribute to improve patient care, however few studies have examined this issue in PD. The present study was devised to describe the type of and reasons for medical healthcare resource use in persons with PD attending a Centre for PD and Movement Disorders, and to examine drug prescriptions issued on such occasions.MethodsThe study was a retrospective, cross-sectional survey in a cohort of ambulatory patients with PD, conducted by means of standard interviews.ResultsIn the year before the study, 92 (70.8%) of 130 patients used medical healthcare resources: 1/5 of the patients was admitted to hospital, 1/5 to emergency room, 2/5 were visited by a non-neurology specialist, and 1/4 by the GP. Reasons were: nearly 20% programmed hospital admissions and visits, and more than 25% injuries and musculo-skeletal diseases. Other conditions typically occurring in PD (e.g. dementia, diabetes and cardio- and cerebro-vascular disease) were less frequently involved. On such occasions, drugs for PD were occasionally changed, however drug prescriptions for other indications were issued to more than 66% of the patients.ConclusionSeveral physicians other than the neurologist may take care of PD patients on different occasions, thus emphasising the need for communication between the reference neurologist and other physicians who from time to time may visit the patient.
Highlights
Parkinson's disease (PD) is a chronic neurodegenerative disease which at present has no cure, and it usually results in severe disability
In the context of a project aimed at investigating healthcare needs, comorbidity, and drug use in PD patients, we previously reported that in PD patients attending a neurological service drug prescribing patterns may be associated with both disease- and patient-related factors, and that analysis of drug prescriptions may help to identify major comorbid conditions [14]
This finding was further supported by stratified analysis of the patients, inasmuch as 35.8% of the patients aged at onset of PD 60 years or more had at least a general practitioner (GP) visit vs 12.2% in patients with earlier PD onset (P = 0.0040), and 41% of the patients with disease duration longer than 8 years were admitted to emergency room (ER) vs 13.5% of those with shorter disease duration (P = 0.0190)
Summary
Parkinson's disease (PD) is a chronic neurodegenerative disease which at present has no cure, and it usually results in severe disability. The burden of PD increases as the illness progresses, resulting in the extensive utilisation of both health and community services. In Europe, age-adjusted prevalence rates of PD have been estimated at 1.6 per 100 population, with a steady increase in older groups, up to 3.5–3.6 in people aged 80 years and older [4]. Because PD is a chronic condition, the disease burden increases as the illness progresses, due to the appearance of both disease- and drug-related problems, resulting in the extensive utilisation of both health and community services [6,7,8,9,10]. It can be predicted that over the few years more PD patients will use more healthcare resources, with a significant impact on the healthcare systems
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