Livskvalitet och resursutnyttjande vid Parkinsons

Quality of life and resource utilization-Swedish data from the Care of Late-Stage Parkinsonism (CLaSP) study

Norlin J M, Hjalte F, Kruse C, Dodel R, Rosqvist K, Odin P

People with late-stage PD is a vulnerable patient group that is costly to society and their HRQoL impairment is immense. This is shown in this article in Parkinson’s disease.

Background
Few studies have investigated the health-related quality of life (HRQoL), resource use and costs in patients with late-stage Parkinson’s disease (PD), and data from the Swedish setting are scarce.

Objectives
First, we analyse the HRQoL in late-stage PD in Sweden. Second, we analyse the resource use and costs per severity level. Third, we analyse the relationship between costs and physician- and patient reported-outcome measures.

Materials and methods
The study was based on Swedish data from the Care of Late-Stage Parkinsonism (CLaSP) study. The costs of healthcare contacts, drugs, formal and informal care, and productivity loss were collected over three months. Assessments at baseline were used for outcomes (EQ-5D, Hoehn and Yahr (H&Y), Schwab and England Scale, Unified Parkinson’s Disease Rating Scale subscales (UPDRS) and Non-Motor Symptoms Scale (NMSS)). Costs were estimated in € 2016.

Results
In total, 106 patients were included. The mean EQ-5D score in the total group was 0.24 (±0.33). The mean total cost excluding informal care per patient in the three-month period was approximately €14,097 (BCa 95% CI €12,007 and €16,039). Professional care accounted for the largest share (75 percent) of the total costs. The EQ-5D, H&Y, Schwab and England Scale, and NMSS were statistically significant predicting factors for total costs.

Conclusion
Patients with late-stage PD are a vulnerable patient group that is costly to society and the impairment in patients’ HRQoL is immense. Thus, healthcare decision-makers should optimize the organization and provision of healthcare for these patients.

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Acta Neurologica Scandinavica, 2022; 00: 1-10
DOI: 10.1111/ane.13611