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Healthcare resource utilization and device-aided therapy discussions with eligible patients across the Parkinson's disease continuum : Revelations from the MANAGE-PD validation cohort

Fernandez, Hubert H. ; Odin, Per LU orcid ; Standaert, David G. ; Henriksen, Tove ; Jimenez-shahed, Joohi ; Metz, Sharon ; Alobaidi, Ali ; Yan, Connie H. ; Kukreja, Pavnit and Parra, Juan Carlos , et al. (2023) In Parkinsonism and Related Disorders 116.
Abstract

Introduction: Device-aided therapy may improve the quality of life (QoL) for people with advanced Parkinson's disease (PD) and poorly controlled symptoms with oral therapy. MANAGE-PD is a validated tool classifying patients based on symptom control and advanced treatment eligibility. This study focused on patient/caregiver reported outcomes and healthcare resource utilization among patients grouped by MANAGE-PD categories. Methods: Device-aided therapy-naïve patients receiving oral treatments were identified from the Adelphi Parkinson's Disease Programme. Patients were categorized (category 1 to 3) using MANAGE-PD. PD-specific QoL (PDQ-39), care partner burden (ZBI), satisfaction with current treatment, healthcare resource utilization,... (More)

Introduction: Device-aided therapy may improve the quality of life (QoL) for people with advanced Parkinson's disease (PD) and poorly controlled symptoms with oral therapy. MANAGE-PD is a validated tool classifying patients based on symptom control and advanced treatment eligibility. This study focused on patient/caregiver reported outcomes and healthcare resource utilization among patients grouped by MANAGE-PD categories. Methods: Device-aided therapy-naïve patients receiving oral treatments were identified from the Adelphi Parkinson's Disease Programme. Patients were categorized (category 1 to 3) using MANAGE-PD. PD-specific QoL (PDQ-39), care partner burden (ZBI), satisfaction with current treatment, healthcare resource utilization, associated healthcare costs, and future treatment discussion with providers were measured. Categories were compared using ANOVA, t-test, chi square and adjusted regression analyses. Results: Of the analytical sample (n = 2709), 18.9% were inadequately controlled on current therapy and potentially eligible for device-aided therapies (category 3). As expected, they had worse patient/caregiver reported outcomes versus patients in categories 1 or 2. However, the degree of difference in healthcare resource utilization, including: greater number of hospitalizations, emergency room (ER) visits and consultations, higher likelihood of being recipients of respite care, and greater PD treatment burden, was unexpected. Importantly, of patients in category 3 and their care partners, >40% did not report discussions with providers about device-aided therapies. Conclusion: MANAGE-PD category 3 patients had significantly higher burden on healthcare resources versus patients well-controlled with oral treatment or requiring only oral medication adjustments; yet almost half had no discussion on device-aided therapies with providers. Device-aided therapies may be considered in these patients.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Device-aided therapy, Healthcare resource utilization, MANAGE-PD, Parkinson's disease, Quality of life, Symptom control
in
Parkinsonism and Related Disorders
volume
116
article number
105514
publisher
Elsevier
external identifiers
  • pmid:37563079
  • scopus:85166904472
ISSN
1353-8020
DOI
10.1016/j.parkreldis.2023.105514
language
English
LU publication?
yes
id
2bb7b44a-0cb2-44e4-ba13-abf9dbf7f2bf
date added to LUP
2023-11-21 14:13:07
date last changed
2024-11-01 13:22:01
@article{2bb7b44a-0cb2-44e4-ba13-abf9dbf7f2bf,
  abstract     = {{<p>Introduction: Device-aided therapy may improve the quality of life (QoL) for people with advanced Parkinson's disease (PD) and poorly controlled symptoms with oral therapy. MANAGE-PD is a validated tool classifying patients based on symptom control and advanced treatment eligibility. This study focused on patient/caregiver reported outcomes and healthcare resource utilization among patients grouped by MANAGE-PD categories. Methods: Device-aided therapy-naïve patients receiving oral treatments were identified from the Adelphi Parkinson's Disease Programme. Patients were categorized (category 1 to 3) using MANAGE-PD. PD-specific QoL (PDQ-39), care partner burden (ZBI), satisfaction with current treatment, healthcare resource utilization, associated healthcare costs, and future treatment discussion with providers were measured. Categories were compared using ANOVA, t-test, chi square and adjusted regression analyses. Results: Of the analytical sample (n = 2709), 18.9% were inadequately controlled on current therapy and potentially eligible for device-aided therapies (category 3). As expected, they had worse patient/caregiver reported outcomes versus patients in categories 1 or 2. However, the degree of difference in healthcare resource utilization, including: greater number of hospitalizations, emergency room (ER) visits and consultations, higher likelihood of being recipients of respite care, and greater PD treatment burden, was unexpected. Importantly, of patients in category 3 and their care partners, &gt;40% did not report discussions with providers about device-aided therapies. Conclusion: MANAGE-PD category 3 patients had significantly higher burden on healthcare resources versus patients well-controlled with oral treatment or requiring only oral medication adjustments; yet almost half had no discussion on device-aided therapies with providers. Device-aided therapies may be considered in these patients.</p>}},
  author       = {{Fernandez, Hubert H. and Odin, Per and Standaert, David G. and Henriksen, Tove and Jimenez-shahed, Joohi and Metz, Sharon and Alobaidi, Ali and Yan, Connie H. and Kukreja, Pavnit and Parra, Juan Carlos and Zamudio, Jorge and Onuk, Koray and Wright, Jack and Antonini, Angelo}},
  issn         = {{1353-8020}},
  keywords     = {{Device-aided therapy; Healthcare resource utilization; MANAGE-PD; Parkinson's disease; Quality of life; Symptom control}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Parkinsonism and Related Disorders}},
  title        = {{Healthcare resource utilization and device-aided therapy discussions with eligible patients across the Parkinson's disease continuum : Revelations from the MANAGE-PD validation cohort}},
  url          = {{http://dx.doi.org/10.1016/j.parkreldis.2023.105514}},
  doi          = {{10.1016/j.parkreldis.2023.105514}},
  volume       = {{116}},
  year         = {{2023}},
}