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Orthostatic hypotension in Parkinson disease: Impact on health care utilization.

Authors :
Merola A
Sawyer RP
Artusi CA
Suri R
Berndt Z
Lopez-Castellanos JR
Vaughan J
Vizcarra JA
Romagnolo A
Espay AJ
Source :
Parkinsonism & related disorders [Parkinsonism Relat Disord] 2018 Feb; Vol. 47, pp. 45-49. Date of Electronic Publication: 2017 Nov 28.
Publication Year :
2018

Abstract

Introduction: Orthostatic hypotension (OH) represents a frequent yet overlooked source of disability in Parkinson disease (PD). In particular, its impact on health care utilization has been insufficiently examined. We sought to determine the differential health care utilization in PD patients with (PDOH+) and without OH (PDOH-).<br />Methods: We quantified the emergency room (ER) visits, hospitalizations, outpatient clinic evaluations, phone calls, and e-mails from PD patients on whom supine and orthostatic blood pressure (BP) measurements were obtained during routine clinical practice between June 2013 and July 2016. Comparative costs between PDOH+ and PDOH- were adjusted for age, disease duration, motor severity, levodopa equivalent daily dose, and Montreal Cognitive Assessment.<br />Results: From a total of 317 PD patients, 29.3% were classified as PDOH+ (n = 93) and 70.6% as PDOH- (n = 224) over 30.2 ± 11.0 months, in which there were 247 hospitalizations, 170 ER visits, 2386 outpatient evaluations, and 4747 telephone calls/e-mails. After-adjusting for relevant covariates, PDOH+ was associated with more hospitalization days (+285%; p = 0.041), ER visits (+152%; p = 0.045), and telephone calls/e-mails than PDOH- (+142%; p = 0.009). The overall health care-related cost in PDOH+ was 2.5-fold higher than for PDOH- ($25,205 ± $6546 vs. $9831 ± $4167/person/year; p = 0.037).<br />Conclusion: OH increases health care utilization in PD independently from age, disease duration, motor severity, dopaminergic treatment, and cognitive function.<br /> (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1873-5126
Volume :
47
Database :
MEDLINE
Journal :
Parkinsonism & related disorders
Publication Type :
Academic Journal
Accession number :
29195729
Full Text :
https://doi.org/10.1016/j.parkreldis.2017.11.344