title: The health burdens of Parkinson's disease.
abstract: Parkinson's disease (PD) is likely to have a substantial impact on an individual's health-related quality of life (HRQL), health-related resource use, and productivity. Data about the health burdens of PD by disease stage are fundamental to understanding the effectiveness of care, both from a clinical and a fiscal point of view. This study's goal was to describe the associations of patient-reported HRQL and economic characteristics with PD stage. We hypothesized that later stages of PD would be associated with poorer HRQL, greater health-related resource use, and lower work productivity than early stages of PD. We used a cross-sectional analysis to study 193 PD patients attending two hospital-based neurology clinics. Self-administered questionnaires and in-person interviews measured clinical features, functional status, general health perceptions, well-being, overall HRQL, work productivity, and health-related resource use. Consistent, strong associations were found between stage and functional status, general health perceptions, well-being, and overall HRQL even after controlling for age, gender, and comorbid conditions. Most resource use and work productivity measures were also associated with disease stage. However, physician services use was not. This study confirms that the burdens of illness are progressively higher for PD patients with early, moderate, and advanced illness. The results suggest that such important facets of the health burden as HRQL and health-related resource use may be seriously misjudged if not carefully measured but inferred from clinical observations alone.
authors.affiliation: Department of Preventive Medicine and Environmental Health, The University of Iowa, Iowa City 52242, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Chrischilles
authors.forename: L M
authors.initials: LM
authors.lastname: Rubenstein
authors.forename: M D
authors.initials: MD
authors.lastname: Voelker
authors.forename: R B
authors.initials: RB
authors.lastname: Wallace
authors.forename: R L
authors.initials: RL
authors.lastname: Rodnitzky
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000191:economics* / Q000523:psychology; D010348:Patient Care Team / Q000191:economics; D010359:Patient Readmission / Q000191:economics; D011788:Quality of Life; D012803:Sick Role; D012959:Socioeconomic Factors