title: Implications for managed care for improving outcomes in Parkinson's disease: balancing aggressive treatment with appropriate care.
abstract: Disability in Parkinson's disease (PD) is due not only to progressive impairment in balance, gait, and motor-related tasks, but also to several nonmotor symptoms affecting autonomic, neuropsychiatric, and sensory functions. The prevalence of PD in the United States is rising due to the expanding elderly population. Direct medical costs associated with PD are significant and influenced by level of disability and associated complexity of management. As new treatments are made available, reevaluation of treatment benefits and paradigms is warranted, for both motor and nonmotor symptoms of PD, to better manage outcomes. In addition to evaluation of symptomatic therapies for PD, attention to advances in disease-modifying therapies and to management of nonmotor symptoms should be an integral component of PD surveillance in the managed care environment.
authors.affiliation: Department of Pharmacotherapy and Outcomes Science, Department of Neurology, School of Medicine, Loma Linda University, Loma Linda, CA, USA. jjchen@llu.edu
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Chen
mesh_terms: D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D015444:Exercise; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D018802:Patient-Centered Care; D026741:Physical Therapy Modalities; D011788:Quality of Life; D018434:Sickness Impact Profile
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa