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. 2021 Apr:85:109-113.
doi: 10.1016/j.parkreldis.2021.03.006. Epub 2021 Mar 18.

Analysis of nationwide multimodal complex treatment and drug pump therapy in Parkinson's disease in times of COVID-19 pandemic in Germany

Daniel Richter  1 , Raphael Scherbaum  1 , Dirk Bartig  2 , Ralf Gold  3 , Christos Krogias  4 , Lars Tönges  5
Affiliations

Analysis of nationwide multimodal complex treatment and drug pump therapy in Parkinson's disease in times of COVID-19 pandemic in Germany

Daniel Richter et al. Parkinsonism Relat Disord. 2021 Apr.

Abstract

Introduction: During the first peak phase of the COVID-19 pandemic, the German Ministry of Health recommended that elective treatments should be postponed to increase hospital capacities. This has also compromised the capacity for application of specialized Parkinson's disease (PD) therapies to an unknown extent.

Methods: We conducted a nationwide cross-sectional study using administrative database of all hospitalized patients with main diagnosis of PD receiving multimodal complex treatment (PD-MCT), initial setup of levodopa/carbidopa intestinal gel (LCIG) or continuous subcutaneous apomorphine infusion (CSAI) in Germany. We compared case numbers and clinical characteristics of the pandemic (March 16th - May 15th, 2020) and post-lockdown (July 16th - September 15th, 2020) period with the pre-pandemic (January 16th - March 15th, 2020) and historical control period (March 16th - May 15th, 2019).

Results: We identified a strong decline for PD-MCT(-62.8%) and for the application of drug pump-based therapies (-69.4%) during the first peak phase of the pandemic as compared to the pre-pandemic period while specialized PD treatment procedures increased again in the post-lockdown phase. Advanced disease was a marker for PD-MCT patients during the pandemic period.

Conclusion: Besides the marked decline in specialized PD treatments during the first peak phase of the COVID-19 pandemic, we found recuperative effects for these procedures in the post-lockdown period without reaching pre-pandemic levels. Strengthening treatment capacities for PD patients, even in the event of a persistent pandemic, is urgently needed in order to maintain the quality of care.

Keywords: Health services; Inpatient; Multimodal care; Parkinson's disease.

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Figures

Fig. 1
Fig. 1
Case numbers for PD-MCT and LCIG/CSAI in Germany during COVID-19 pandemic. Legend: Bar chart demonstrating the absolute numbers of (A) PD-MCT and (B) LCIG/CSAI for the respective time periods: historical period (March 16th - May 15th, 2019), pre-pandemic period January 16th - March 15th, 2020), pandemic period (March 16th - May 15th, 2020) and post-lockdown period (July 16th - September 15th, 2020). Schematic course of the number of hospitalized COVID-19 cases in Germany is given as curve diagram (red). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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References

    1. Müller T., Öhm G., Eilert K., Möhr K., Rotter S., Haas T., Küchler M., Lütge S., Marg M., Rothe H. Benefit on motor and non-motor behavior in a specialized unit for Parkinson's disease. J. Neural. Transm. 2017;124(6):715–720. - PubMed
    1. L Ypinga J.H., de Vries N.M., M Boonen L.H.H., Koolman X., Munneke M., Zwinderman A.H., Bloem B.R. Effectiveness and costs of specialised physiotherapy given via ParkinsonNet: a retrospective analysis of medical claims data. Lancet Neurol. 2018;17(2):153–161. - PubMed
    1. Ferrazzoli D., Ortelli P., Zivi I., Cian V., Urso E., Ghilardi M.F., Maestri R., Frazzitta G. Efficacy of intensive multidisciplinary rehabilitation in Parkinson's disease: a randomised controlled study. J. Neurol. Neurosurg. Psychiatry. 2017;89(8):828–835. - PMC - PubMed
    1. Scherbaum R., Hartelt E., Kinkel M., Gold R., Muhlack S., Tönges L. Parkinson's Disease Multimodal Complex Treatment improves motor symptoms, depression and quality of life. J. Neurol. 2020;267(4):954–965. - PubMed
    1. Hartelt E., Scherbaum R., Kinkel M., Gold R., Muhlack S., Tönges L. Parkinson's disease multimodal complex treatment (PD-PD-MCT): analysis of therapeutic effects and predictors for improvement. J. Clin. Med. 2020;9(6):1874. - PMC - PubMed

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