Clinical Impact and Cost-Effectiveness of an Education Program for PD Patients: A Randomized Controlled Trial.
BACKGROUND
Parkinson's disease (PD) is characterized by its impact on quality of life, constituting a substantial economic burden on society. Education programs implicating patients more in the management of their illness and complementing medical treatment may be a beneficial adjunct in PD. This study assessed the impact of an education program on quality of life and its cost-effectiveness in PD patients.


METHODS
This single-center, prospective, randomized study assessed an education program consisting of individual and group sessions over a 12-month period. A total of 120 PD patients were assigned to either the Treated by Behavioral Intervention group (TTBI) or the no TTBI group. The primary outcome criterion was quality of life assessed using PDQ39. The Unified Parkinson's Disease Rating Scale (UPDRS) and psychological status were collected. An economic evaluation was performed, including calculations of incremental cost-effectiveness ratios (ICERs).


RESULTS
After 12 months of follow-up, changes recorded in the PDQ39 between the groups were not significantly different but better changes were observed in each dimension in the TTBI group compared to the no TTBI group. UPDRS I, II and total score were significantly improved in TTBI group compared to the no TTBI group. Mean annual costs did not differ significantly between the two groups.


CONCLUSIONS
This study suggested that the education program positively impacts the perceived health of PD patients without increasing medical costs.
Department of Neurology, University Hospital, Toulouse, France.
Cindy
C
Canivet
Department of Medical Information, University Hospital, Toulouse, France.|INSERM UMR1027, Toulouse, France.
Nadège
N
Costa
Department of Neurology, University Hospital, Toulouse, France.
Fabienne
F
Ory-Magne
Department of Neurology, University Hospital, Toulouse, France.
Céline
C
Arcari
Department of Neurology, University Hospital, Toulouse, France.
Christine
C
Mohara
Unité de pharmacoépidémiologie, Faculté de Médecine, Toulouse, France.
Laure
L
Pourcel
Department of Medical Information, University Hospital, Toulouse, France.
Hélène
H
Derumeaux
Département d'Epidémiologie, Economie de la Santé et Santé Publique, UMR 1027 INSERM, Université de Toulouse III, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Emilie
E
Bérard
Direction Régionale du Service du Contrôle Médical, Assurance Maladie, Toulouse, France.
Robert
R
Bourrel
Department of Medical Information, University Hospital, Toulouse, France.|INSERM UMR1027, Toulouse, France.
Laurent
L
Molinier
Department of Neurology, University Hospital, Toulouse, France.|Department of Clinical Pharmacology, University Hospital, Toulouse, France.|Inserm, Imagerie cérébrale et handicaps neurologiques, UMR 825, F-31059 Toulouse, France.
Christine
C
Brefel-Courbon
Arch Neurol. 1996 Sep;53(9):881-4
8815853
Parkinsonism Relat Disord. 2012 Aug;18(7):828-32
22542396
Rev Neurol (Paris). 2014 Feb;170(2):128-33
24267951
Parkinsonism Relat Disord. 2006 Dec;12(8):478-85
16781881
Mov Disord. 2000 Nov;15(6):1112-8
11104193
Ann Phys Rehabil Med. 2011 Mar;54(2):109-28
21388907
Am J Med. 1994 Nov;97(5):429-35
7977431
Eur Neuropsychopharmacol. 2011 Feb;21(2):180-91
20888737
Patient Educ Couns. 2007 Feb;65(2):245-52
16965885
Qual Life Res. 2004 Feb;13(1):81-9
15058790
J Clin Nurs. 2007 Nov;16(11C):368-76
17931329
Neurology. 2001 Sep 11;57(5):790-4
11552005
Eur Neuropsychopharmacol. 2005 Aug;15(4):473-90
15963700
Eur J Neurol. 2005 Jun;12 Suppl 1:68-73
15877783
Qual Life Res. 2010 Feb;19(1):55-64
19946755
Age Ageing. 1997 Sep;26(5):353-7
9351479
BMC Neurol. 2007 Jul 16;7:20
17634109
Mov Disord. 2013 Jun;28(6):763-71
23576266
Eur J Neurol. 2005 Jun;12 Suppl 1:1-27
15877774
Age Ageing. 2001 Jul;30(4):299-302
11509307
Mov Disord. 2003 May;18(5):578-84
12722173
Pharmacoeconomics. 1999 Jul;16(1):59-69
10539122
Can J Neurol Sci. 2009 Jan;36(1):51-9
19294889