Tove Henriksen1, Kim Peder Dalhoff2,3, Henriette Engel Hansen4, Andreas W Brenneche5, Ulla Sofie Lønberg5, Erik Hvid Danielsen6. 1. Movement Disorder Clinic, Department of Neurology Bispebjerg Hospital Copenhagen Denmark. 2. Department of Clinical Pharmacology Bispebjerg Hospital Copenhagen Denmark. 3. Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark. 4. COWI A/S Kongens Lyngby Denmark. 5. AbbVie A/S Copenhagen Denmark. 6. Department of Neurology Aarhus University Hospital Aarhus Denmark.
Abstract
BACKGROUND: In Denmark's five regions, there is potential inequality in access to device-aided therapy (DAT) for Parkinson's disease (PD) based on structural or socioeconomic factors. It is unclear how long DAT is maintained and affects concomitant medication. OBJECTIVES: To investigate access to DAT by comparing the proportion of patients with DBS, subcutaneous apomorphine infusion (SCAI), or levodopa/carbidopa intestinal gel (LCIG) in Danish regions 2008-2016 and describe demographics of patients, changes in use of comedication, and maintenance of DAT. METHODS: This work is a retrospective nationwide population-based registry analysis generated by combining various registries and statistics in Denmark. RESULTS: From 2008 to 2016, 612 patients started DAT. There were statistically significant differences in the number of patients starting DAT between the Capital Region (99.5 per 1,000) and both Central Jutland (66.6 per 1,000) and North Jutland (70.6 per 1,000; P < 0.05). Among DBS and LCIG patients, respectively, 4% and 42% were aged ≥70 years, 68% and 63% were men (vs. 59% in the general PD population; P < 0.05 for DBS), 73% and 63% had a partner (vs. 62% in the general PD population), and 73% and 71% had a qualifying education (vs. 63% in the general PD population; P < 0.05). Use of PD-related medication decreased significantly from 4 years before to 4 years after DAT. Eighty-one percent of the patients who started LCIG, alive 4 years later, had maintained this treatment. CONCLUSIONS: There is unequal access to DAT in the Danish regions, and political and social considerations are warranted to address structural and socioeconomic causes.
BACKGROUND: In Denmark's five regions, there is potential inequality in access to device-aided therapy (DAT) for Parkinson's disease (PD) based on structural or socioeconomic factors. It is unclear how long DAT is maintained and affects concomitant medication. OBJECTIVES: To investigate access to DAT by comparing the proportion of patients with DBS, subcutaneous apomorphine infusion (SCAI), or levodopa/carbidopa intestinal gel (LCIG) in Danish regions 2008-2016 and describe demographics of patients, changes in use of comedication, and maintenance of DAT. METHODS: This work is a retrospective nationwide population-based registry analysis generated by combining various registries and statistics in Denmark. RESULTS: From 2008 to 2016, 612 patients started DAT. There were statistically significant differences in the number of patients starting DAT between the Capital Region (99.5 per 1,000) and both Central Jutland (66.6 per 1,000) and North Jutland (70.6 per 1,000; P < 0.05). Among DBS and LCIG patients, respectively, 4% and 42% were aged ≥70 years, 68% and 63% were men (vs. 59% in the general PD population; P < 0.05 for DBS), 73% and 63% had a partner (vs. 62% in the general PD population), and 73% and 71% had a qualifying education (vs. 63% in the general PD population; P < 0.05). Use of PD-related medication decreased significantly from 4 years before to 4 years after DAT. Eighty-one percent of the patients who started LCIG, alive 4 years later, had maintained this treatment. CONCLUSIONS: There is unequal access to DAT in the Danish regions, and political and social considerations are warranted to address structural and socioeconomic causes.
Authors: Frouke A P Nijhuis; Jolien van Heek; Bastiaan R Bloem; Bart Post; Marjan J Faber Journal: J Parkinsons Dis Date: 2016-07-25 Impact factor: 5.568
Authors: Allison W Willis; Mario Schootman; Nathan Kung; Xiao-Yu Wang; Joel S Perlmutter; Brad A Racette Journal: Neurology Date: 2013-12-11 Impact factor: 9.910
Authors: Werner Poewe; Klaus Seppi; Caroline M Tanner; Glenda M Halliday; Patrik Brundin; Jens Volkmann; Anette-Eleonore Schrag; Anthony E Lang Journal: Nat Rev Dis Primers Date: 2017-03-23 Impact factor: 52.329
Authors: Angelo Antonini; A Jon Stoessl; Leah S Kleinman; Anne M Skalicky; Thomas S Marshall; Kavita R Sail; Koray Onuk; Per Lars Anders Odin Journal: Curr Med Res Opin Date: 2018-08-20 Impact factor: 2.580
Authors: Marieke G M Weernink; Janine A van Til; Jeroen P P van Vugt; Kris L L Movig; Catharina G M Groothuis-Oudshoorn; Maarten J IJzerman Journal: PLoS One Date: 2016-08-30 Impact factor: 3.240