Clinical Impact and Cost-Effectiveness of an Education Program for PD Patients: A Randomized Controlled Trial
Identifieur interne : 000331 ( Main/Exploration ); précédent : 000330; suivant : 000332Clinical Impact and Cost-Effectiveness of an Education Program for PD Patients: A Randomized Controlled Trial
Auteurs : Cindy Canivet [France] ; Nadège Costa [France] ; Fabienne Ory-Magne [France] ; Céline Arcari [France] ; Christine Mohara [France] ; Laure Pourcel [France] ; Hélène Derumeaux [France] ; Emilie Bérard [France] ; Robert Bourrel [France] ; Laurent Molinier [France] ; Christine Brefel-Courbon [France]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
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.
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).
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.
This study suggested that the education program positively impacts the perceived health of PD patients without increasing medical costs.
Url:
DOI: 10.1371/journal.pone.0162646
PubMed: 27685455
PubMed Central: 5042480
Affiliations:
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Neurology, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Costa, Nadege" sort="Costa, Nadege" uniqKey="Costa N" first="Nadège" last="Costa">Nadège Costa</name><affiliation wicri:level="3"><nlm:aff id="aff002"><addr-line>Department of Medical Information, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Medical Information, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff003"><addr-line>INSERM UMR1027, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INSERM UMR1027, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Ory Magne, Fabienne" sort="Ory Magne, Fabienne" uniqKey="Ory Magne F" first="Fabienne" last="Ory-Magne">Fabienne Ory-Magne</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Neurology, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Arcari, Celine" sort="Arcari, Celine" uniqKey="Arcari C" first="Céline" last="Arcari">Céline Arcari</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Neurology, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Mohara, Christine" sort="Mohara, Christine" uniqKey="Mohara C" first="Christine" last="Mohara">Christine Mohara</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Neurology, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Pourcel, Laure" sort="Pourcel, Laure" uniqKey="Pourcel L" first="Laure" last="Pourcel">Laure Pourcel</name><affiliation wicri:level="3"><nlm:aff id="aff004"><addr-line>Unité de pharmacoépidémiologie, Faculté de Médecine, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Unité de pharmacoépidémiologie, Faculté de Médecine, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Derumeaux, Helene" sort="Derumeaux, Helene" uniqKey="Derumeaux H" first="Hélène" last="Derumeaux">Hélène Derumeaux</name><affiliation wicri:level="3"><nlm:aff id="aff002"><addr-line>Department of Medical Information, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Medical Information, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Berard, Emilie" sort="Berard, Emilie" uniqKey="Berard E" first="Emilie" last="Bérard">Emilie Bérard</name><affiliation wicri:level="3"><nlm:aff id="aff007"><addr-line>Département d’Epidémiologie, Economie de la Santé et Santé Publique, UMR 1027 INSERM, Université de Toulouse III, Centre Hospitalier Universitaire de Toulouse, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Département d’Epidémiologie, Economie de la Santé et Santé Publique, UMR 1027 INSERM, Université de Toulouse III, Centre Hospitalier Universitaire de Toulouse, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Bourrel, Robert" sort="Bourrel, Robert" uniqKey="Bourrel R" first="Robert" last="Bourrel">Robert Bourrel</name><affiliation wicri:level="3"><nlm:aff id="aff008"><addr-line>Direction Régionale du Service du Contrôle Médical, Assurance Maladie, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Direction Régionale du Service du Contrôle Médical, Assurance Maladie, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Molinier, Laurent" sort="Molinier, Laurent" uniqKey="Molinier L" first="Laurent" last="Molinier">Laurent Molinier</name><affiliation wicri:level="3"><nlm:aff id="aff002"><addr-line>Department of Medical Information, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Medical Information, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff003"><addr-line>INSERM UMR1027, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INSERM UMR1027, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Brefel Courbon, Christine" sort="Brefel Courbon, Christine" uniqKey="Brefel Courbon C" first="Christine" last="Brefel-Courbon">Christine Brefel-Courbon</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Neurology, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Department of Clinical Pharmacology, University Hospital, Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical Pharmacology, University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff006"><addr-line>Inserm, Imagerie cérébrale et handicaps neurologiques, UMR 825, F-31059 Toulouse, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Inserm, Imagerie cérébrale et handicaps neurologiques, UMR 825, F-31059 Toulouse</wicri:regionArea><placeName><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>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.</p></sec><sec id="sec002"><title>Methods</title><p>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).</p></sec><sec id="sec003"><title>Results</title><p>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.</p></sec><sec id="sec004"><title>Conclusion</title><p>This study suggested that the education program positively impacts the perceived health of PD patients without increasing medical costs.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Von Campenhausen, S" uniqKey="Von Campenhausen S">S Von Campenhausen</name></author><author><name sortKey="Bornschein, B" uniqKey="Bornschein B">B Bornschein</name></author><author><name sortKey="Wick, R" uniqKey="Wick R">R Wick</name></author><author><name sortKey="Botzel, K" uniqKey="Botzel K">K Bötzel</name></author><author><name sortKey="Sampaio, C" uniqKey="Sampaio C">C Sampaio</name></author><author><name sortKey="Poewe, W" uniqKey="Poewe W">W Poewe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schrag, A" uniqKey="Schrag A">A Schrag</name></author><author><name 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uniqKey="Smith Pasqualini M">MC Smith Pasqualini</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shimbo, T" uniqKey="Shimbo T">T Shimbo</name></author><author><name sortKey="Goto, M" uniqKey="Goto M">M Goto</name></author><author><name sortKey="Morimoto, T" uniqKey="Morimoto T">T Morimoto</name></author><author><name sortKey="Hira, K" uniqKey="Hira K">K Hira</name></author><author><name sortKey="Takemura, M" uniqKey="Takemura M">M Takemura</name></author><author><name sortKey="Matsui, K" uniqKey="Matsui K">K Matsui</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Montgomery, Eb" uniqKey="Montgomery E">EB Montgomery</name></author><author><name sortKey="Lieberman, A" uniqKey="Lieberman A">A Lieberman</name></author><author><name sortKey="Singh, G" uniqKey="Singh G">G Singh</name></author><author><name sortKey="Fries, Jf" uniqKey="Fries J">JF 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uniqKey="Demaille Wlodyka S">S Demaille-Wlodyka</name></author><author><name sortKey="Donze, C" uniqKey="Donze C">C Donze</name></author><author><name sortKey="Givron, P" uniqKey="Givron P">P Givron</name></author><author><name sortKey="Gallien, P" uniqKey="Gallien P">P Gallien</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peto, V" uniqKey="Peto V">V Peto</name></author><author><name sortKey="Jenkinson, C" uniqKey="Jenkinson C">C Jenkinson</name></author><author><name sortKey="Fitzpatrick, R" uniqKey="Fitzpatrick R">R Fitzpatrick</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lindskov, S" uniqKey="Lindskov S">S Lindskov</name></author><author><name sortKey="Westergren, A" uniqKey="Westergren A">A Westergren</name></author><author><name sortKey="Hagell, P" uniqKey="Hagell P">P Hagell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lindgren, P" uniqKey="Lindgren P">P Lindgren</name></author><author><name sortKey="Von Campenhausen, S" uniqKey="Von Campenhausen S">S von Campenhausen</name></author><author><name sortKey="Spottke, E" uniqKey="Spottke E">E Spottke</name></author><author><name sortKey="Siebert, U" uniqKey="Siebert U">U Siebert</name></author><author><name sortKey="Dodel, R" uniqKey="Dodel R">R Dodel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Von Campenhausen, S" uniqKey="Von Campenhausen S">S Von Campenhausen</name></author><author><name sortKey="Winter, Y" uniqKey="Winter Y">Y Winter</name></author><author><name sortKey="Rodrigues E Silva, A" uniqKey="Rodrigues E Silva A">A Rodrigues e Silva</name></author><author><name sortKey="Sampaio, C" uniqKey="Sampaio C">C Sampaio</name></author><author><name sortKey="Ruzicka, E" uniqKey="Ruzicka E">E Ruzicka</name></author><author><name sortKey="Barone, P" uniqKey="Barone P">P Barone</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lepen, C1" uniqKey="Lepen C">C1 LePen</name></author><author><name sortKey="Wait, S" uniqKey="Wait S">S Wait</name></author><author><name sortKey="Moutard Martin, F" uniqKey="Moutard Martin F">F Moutard-Martin</name></author><author><name sortKey="Dujardin, M" uniqKey="Dujardin M">M Dujardin</name></author><author><name sortKey="Ziegler, M" uniqKey="Ziegler M">M Ziégler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dams, J" uniqKey="Dams J">J Dams</name></author><author><name sortKey="Siebert, U" uniqKey="Siebert U">U Siebert</name></author><author><name sortKey="Bornschein, B" uniqKey="Bornschein B">B Bornschein</name></author><author><name sortKey="Volkmann, J" uniqKey="Volkmann J">J Volkmann</name></author><author><name sortKey="Deuschl, G" uniqKey="Deuschl G">G Deuschl</name></author><author><name sortKey="Oertel, Wh" uniqKey="Oertel W">WH Oertel</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li></country><region><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li></region><settlement><li>Toulouse</li></settlement></list><tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Canivet, Cindy" sort="Canivet, Cindy" uniqKey="Canivet C" first="Cindy" last="Canivet">Cindy Canivet</name></region><name sortKey="Arcari, Celine" sort="Arcari, Celine" uniqKey="Arcari C" first="Céline" last="Arcari">Céline Arcari</name><name sortKey="Berard, Emilie" sort="Berard, Emilie" uniqKey="Berard E" first="Emilie" last="Bérard">Emilie Bérard</name><name sortKey="Bourrel, Robert" sort="Bourrel, Robert" uniqKey="Bourrel R" first="Robert" last="Bourrel">Robert Bourrel</name><name sortKey="Brefel Courbon, Christine" sort="Brefel Courbon, Christine" uniqKey="Brefel Courbon C" first="Christine" last="Brefel-Courbon">Christine Brefel-Courbon</name><name sortKey="Brefel Courbon, Christine" sort="Brefel Courbon, Christine" uniqKey="Brefel Courbon C" first="Christine" last="Brefel-Courbon">Christine Brefel-Courbon</name><name sortKey="Brefel Courbon, Christine" sort="Brefel Courbon, Christine" uniqKey="Brefel Courbon C" first="Christine" last="Brefel-Courbon">Christine Brefel-Courbon</name><name sortKey="Costa, Nadege" sort="Costa, Nadege" uniqKey="Costa N" first="Nadège" last="Costa">Nadège Costa</name><name sortKey="Costa, Nadege" sort="Costa, Nadege" uniqKey="Costa N" first="Nadège" last="Costa">Nadège Costa</name><name sortKey="Derumeaux, Helene" sort="Derumeaux, Helene" uniqKey="Derumeaux H" first="Hélène" last="Derumeaux">Hélène Derumeaux</name><name sortKey="Mohara, Christine" sort="Mohara, Christine" uniqKey="Mohara C" first="Christine" last="Mohara">Christine Mohara</name><name sortKey="Molinier, Laurent" sort="Molinier, Laurent" uniqKey="Molinier L" first="Laurent" last="Molinier">Laurent Molinier</name><name sortKey="Molinier, Laurent" sort="Molinier, Laurent" uniqKey="Molinier L" first="Laurent" last="Molinier">Laurent Molinier</name><name sortKey="Ory Magne, Fabienne" sort="Ory Magne, Fabienne" uniqKey="Ory Magne F" first="Fabienne" last="Ory-Magne">Fabienne Ory-Magne</name><name sortKey="Pourcel, Laure" sort="Pourcel, Laure" uniqKey="Pourcel L" first="Laure" last="Pourcel">Laure Pourcel</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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