1. Mobility, mood and site of care impact health related quality of life in Parkinson's disease.
- Author
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Nutt, J.G., Siderowf, A.D., Guttman, M., Schmidt, P.N., Zamudio, J.I., Wu, S.S., Okun, M.S., Simuni, T., Parashos, S.A., Dahodwala, N.A., Davis, T.L., Giladi, N., Gurevich, T., Hauser, R.A., Jankovic, J., Lyons, K.E., Marsh, L., Miyasaki, J.M., Morgan, J.C., and Santiago, A.J.
- Subjects
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CARE of Parkinson's disease patients , *HEALTH impact assessment , *HEALTH outcome assessment , *COHORT analysis , *QUALITY of life , *CENTERS of excellence (Medical care) - Abstract
Abstract: Objective: Examine the correlates of Health Related Quality of Life (HRQL) in a large cohort of Parkinson's disease (PD) patients from National Parkinson Foundation (NPF) Centers of Excellence (COEs). Background: Improving outcomes for PD will depend upon uncovering disease features impacting HRQL to identify targets for intervention and variables for risk-adjustment models. Differences in HRQL outcomes between COEs could uncover modifiable aspects of care delivery. Methods: This cross-sectional study examined the relative contribution of demographic, social, clinical and treatment features potentially related to HRQL, as measured by the PDQ-39, in 4601 consecutive subjects from 18 COEs. Stepwise linear regression was utilized to identify correlates of HRQL. Results: The variability in the PDQ-39 summary index score correlated with H&Y stage (R 2 = 22%), Timed up and Go (TUG) (17%), disease duration (11%), comorbidities (8%), cognitive status (8%), antidepressant use (6%) and center at which a patient received care (5%). Stepwise regression reordered the importance of the variables, with the H&Y first and TUG and the center becoming equal and the second most important variables determining the PDQ-39 total score. All independent variables together accounted for 44% of the variability in HRQL. Conclusions: We confirmed many but not all HRQL associations found in smaller studies. A novel observation was that the site of care was an important contributor to HRQL, suggesting that comparison of outcomes and processes among centers may identify best practices. [Copyright &y& Elsevier]
- Published
- 2014
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