Care of Late-Stage Parkinsonism: Resource Utilization of the Disease in Five European Countries

Christopher Kruse¹, Anna Lipinski^{1

2}, Malte Verheyen¹, Monika Balzer-Geldsetzer^{1

2}, Michael Wittenberg³, Stefan Lorenzl^{4

5}, Carmen Richinger⁵, Christian Schmotz⁵, Lars Tönges^{6

7}, Dirk Woitalla⁸, Stephan Klebe⁹, Bastiaan R Bloem¹⁰, Adrianus Hommel¹⁰, Wassilios G Meissner¹¹, Brice Laurens¹¹, Thomas Boraud¹¹, Alexandra Foubert-Samier¹¹, Sylvain Vergnet¹¹, François Tison¹¹, Nadège Costa¹², Per Odin¹³, Kristina Rosqvist¹³, Jenny M Norlin¹⁴, Frida Hjalte¹⁴, Anette Schrag¹⁵, Richard Dodel^{1

2}

Affiliations

¹ Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany.
² Department of Neurology, Philipps-University Marburg, Marburg, Germany.
³ Coordination Center for Clinical Trials of the Philipps-University Marburg, Marburg, Germany.
⁴ Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
⁵ Institute of Palliative Care, Paracelsus Medical University, Salzburg, Austria.
⁶ Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany.
⁷ Neurodegeneration Research, Centre for Protein Diagnostics (ProDi), Ruhr-University, Bochum, Germany.
⁸ Department of Neurology, St. Josef-Krankenhaus Kupferdreh, Essen, Germany.
⁹ Department of Neurology, Essen University Hospital, Essen, Germany.
¹⁰ Department of Neurology, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.
¹¹ Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France.
¹² Health Economic Unit, Medical Information Department, University Hospital, Toulouse, France.
¹³ Division of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden.
¹⁴ The Swedish Institute for Health Economics, Lund, Sweden.
¹⁵ Department of Clinical Neurosciences, UCL Institute of Neurology, University College London, London, UK.

PMID: 38425158
DOI: 10.1002/mds.29718

Care of Late-Stage Parkinsonism: Resource Utilization of the Disease in Five European Countries

Christopher Kruse et al. Mov Disord. 2024 Mar.

. 2024 Mar;39(3):571-584.

doi: 10.1002/mds.29718. Epub 2024 Feb 29.

Authors

Affiliations

¹ Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany.
² Department of Neurology, Philipps-University Marburg, Marburg, Germany.
³ Coordination Center for Clinical Trials of the Philipps-University Marburg, Marburg, Germany.
⁴ Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
⁵ Institute of Palliative Care, Paracelsus Medical University, Salzburg, Austria.
⁶ Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany.
⁷ Neurodegeneration Research, Centre for Protein Diagnostics (ProDi), Ruhr-University, Bochum, Germany.
⁸ Department of Neurology, St. Josef-Krankenhaus Kupferdreh, Essen, Germany.
⁹ Department of Neurology, Essen University Hospital, Essen, Germany.
¹⁰ Department of Neurology, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.
¹¹ Service de Neurologie des Maladies Neurodégénératives, Bordeaux, France and University of Bordeaux, CNRS, IMN, UMR, Bordeaux, France.
¹² Health Economic Unit, Medical Information Department, University Hospital, Toulouse, France.
¹³ Division of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden.
¹⁴ The Swedish Institute for Health Economics, Lund, Sweden.
¹⁵ Department of Clinical Neurosciences, UCL Institute of Neurology, University College London, London, UK.

PMID: 38425158
DOI: 10.1002/mds.29718

Abstract

Background: Parkinson's disease (PD) is a neurodegenerative disease that leads to progressive disability. Cost studies have mainly explored the early stages of the disease, whereas late-stage patients are underrepresented.

Objective: The aim is to evaluate the resource utilization and costs of PD management in people with late-stage disease.

Methods: The Care of Late-Stage Parkinsonism (CLaSP) study collected economic data from patients with late-stage PD and their caregivers in five European countries (France, Germany, the Netherlands, UK, Sweden) in a range of different settings. Patients were eligible to be included if they were in Hoehn and Yahr stage >3 in the on state or Schwab and England stage at 50% or less. In total, 592 patients met the inclusion criteria and provided information on their resource utilization. Costs were calculated from a societal perspective for a 3-month period. A least absolute shrinkage and selection operator approach was utilized to identify the most influential independent variables for explaining and predicting costs.

Results: During the 3-month period, the costs were €20,573 (France), €19,959 (Germany), €18,319 (the Netherlands), €25,649 (Sweden), and €12,156 (UK). The main contributors across sites were formal care, hospitalization, and informal care. Gender, age, duration of the disease, Unified Parkinson's Disease Rating Scale 2, the EQ-5D-3L, and the Schwab and England Scale were identified as predictors of costs.

Conclusion: Costs in this cohort of individuals with late-stage PD were substantially higher compared to previously published data on individuals living in earlier stages of the disease. Resource utilization in the individual sites differed in part considerably among these three parameters mentioned. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keywords: Parkinson's disease; cost‐of‐illness; late‐stage parkinsonism; resource utilization.

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References

1. Dorsey ER, Elbaz A, Nichols E, et al. Global, regional, and national burden of Parkinson's disease, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 2018;17(11):939–953. https://doi.org/10.1016/S1474-4422(18)30295-3
1. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967;17(5):427–442. https://doi.org/10.1212/wnl.17.5.427
1. Coelho M, Ferreira J, Rosa M, Sampaio C. Treatment options for non‐motor symptoms in late‐stage Parkinson's disease. Expert Opin Pharmacother 2008;9(4):523–535. https://doi.org/10.1517/14656566.9.4.523
1. Hely MA, Morris JGL, Reid WGJ, Trafficante R. Sydney multicenter study of Parkinson's disease: non‐L‐dopa‐responsive problems dominate at 15 years. Mov Disord 2005;20(2):190–199. https://doi.org/10.1002/mds.20324
1. Tolosa E, Wenning G, Poewe W. The diagnosis of Parkinson's disease. Lancet Neurol 2006;5(1):75–86. https://doi.org/10.1016/S1474-4422(05)70285-4

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Care of Late-Stage Parkinsonism: Resource Utilization of the Disease in Five European Countries

Affiliations

Care of Late-Stage Parkinsonism: Resource Utilization of the Disease in Five European Countries

Authors

Affiliations

Abstract

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous