[Social and economic cost of L-Dopa-induced dyskinesias in patients with Parkinson's disease].
Identifieur interne : 001105 ( PubMed/Checkpoint ); précédent : 001104; suivant : 001106[Social and economic cost of L-Dopa-induced dyskinesias in patients with Parkinson's disease].
Auteurs : F. Maurel [France] ; H. Lilliu ; C. Le PenSource :
- Revue neurologique [ 0035-3787 ] ; 2001.
Descripteurs français
- Wicri :
- geographic : France.
English descriptors
- KwdEn :
- Age Distribution, Aged, Aged, 80 and over, Antiparkinson Agents (adverse effects), Antiparkinson Agents (economics), Dyskinesia, Drug-Induced (diagnosis), Dyskinesia, Drug-Induced (economics), Dyskinesia, Drug-Induced (etiology), Female, France (epidemiology), Health Care Costs, Humans, Levodopa (adverse effects), Levodopa (economics), Male, Parkinson Disease (drug therapy), Parkinson Disease (economics), Parkinson Disease (epidemiology), Quality of Life, Retrospective Studies, Severity of Illness Index, Sex Distribution.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- chemical , economics : Antiparkinson Agents, Levodopa.
- geographic , epidemiology : France.
- diagnosis : Dyskinesia, Drug-Induced.
- drug therapy : Parkinson Disease.
- economics : Dyskinesia, Drug-Induced, Parkinson Disease.
- epidemiology : Parkinson Disease.
- etiology : Dyskinesia, Drug-Induced.
- Age Distribution, Aged, Aged, 80 and over, Female, Health Care Costs, Humans, Male, Quality of Life, Retrospective Studies, Severity of Illness Index, Sex Distribution.
Abstract
Long term L-Dopa medication mainly induces two complications in Parkinson's Disease (PD) patients, i.e. motor fluctuations and dyskinesias. Both of these complications can significantly impair the patient's quality of life. At a high degree of severity, dyskinesias can interfere with everyday tasks, balance, speech, etc. From a clinical point of view, they lead to complicated L-Dopa dose adjustments or to the use of sustained release forms. For these reasons, L-Dopa-induced dyskinesias may have a significant human and financial impact. We have designed a retrospective study to explore two aspects of PD, i.e. the impact of dyskinesias on patient's social life and their economic cost. Ten French neurologists were randomly selected from a national file to participate in this study. They were asked to include 4 patients with PD currently under L-Dopa medication and showing 4 different levels of dyskinesia severity, i.e. absent, moderate, mild and severe dyskinesia, according to the Unified Parkinson Disease Rating Scale, with no other specific inclusion criteria. Two specific scales were to be completed, Hoehn & Yahr on disease severity and Schwab & England on degree of independence. Clinical profiles of patients, demographics and use of medical resources were also recorded. Investigators were interviewed about their practice. This study showed that patients with dyskinesias had an earlier onset of the disease (11.2 years vs. 3.7 years). They also had a higher level of disease severity, according to the Hoehn & Yahr scale (40p. cent vs. 0p. cent presenting a level of 4). The mean monthly cost was significantly higher for patients with dyskinesias (FF 3 733 versus FF 1 109, p=0.0005). Particularly, the presence of dyskinesias had a significant impact on treatment costs and medical visits. A positive gradient of the medical cost with level of dyskinesia severity was also underlined. In the same way, the more severe the dyskinesia status the greater the need for caregivers. Finally, based on these results, the total annual medical cost of dyskinesias in France was estimated between 588 and 812 million francs.
PubMed: 11438770
Affiliations:
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Maurel</name><affiliation wicri:level="3"><nlm:affiliation>CLP-Sante, 20, rue de Boulainvilliers, 75016 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CLP-Sante, 20, rue de Boulainvilliers, 75016 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Lilliu, H" sort="Lilliu, H" uniqKey="Lilliu H" first="H" last="Lilliu">H. Lilliu</name></author><author><name sortKey="Le Pen, C" sort="Le Pen, C" uniqKey="Le Pen C" first="C" last="Le Pen">C. Le Pen</name></author></analytic><series><title level="j">Revue neurologique</title><idno type="ISSN">0035-3787</idno><imprint><date when="2001" type="published">2001</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Distribution</term><term>Aged</term><term>Aged, 80 and over</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (economics)</term><term>Dyskinesia, Drug-Induced (diagnosis)</term><term>Dyskinesia, Drug-Induced (economics)</term><term>Dyskinesia, Drug-Induced (etiology)</term><term>Female</term><term>France (epidemiology)</term><term>Health Care Costs</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Levodopa (economics)</term><term>Male</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (economics)</term><term>Parkinson Disease (epidemiology)</term><term>Quality of Life</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Sex Distribution</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>France</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Dyskinesia, Drug-Induced</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age Distribution</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Health Care Costs</term><term>Humans</term><term>Male</term><term>Quality of Life</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Sex Distribution</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>France</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Long term L-Dopa medication mainly induces two complications in Parkinson's Disease (PD) patients, i.e. motor fluctuations and dyskinesias. Both of these complications can significantly impair the patient's quality of life. At a high degree of severity, dyskinesias can interfere with everyday tasks, balance, speech, etc. From a clinical point of view, they lead to complicated L-Dopa dose adjustments or to the use of sustained release forms. For these reasons, L-Dopa-induced dyskinesias may have a significant human and financial impact. We have designed a retrospective study to explore two aspects of PD, i.e. the impact of dyskinesias on patient's social life and their economic cost. Ten French neurologists were randomly selected from a national file to participate in this study. They were asked to include 4 patients with PD currently under L-Dopa medication and showing 4 different levels of dyskinesia severity, i.e. absent, moderate, mild and severe dyskinesia, according to the Unified Parkinson Disease Rating Scale, with no other specific inclusion criteria. Two specific scales were to be completed, Hoehn & Yahr on disease severity and Schwab & England on degree of independence. Clinical profiles of patients, demographics and use of medical resources were also recorded. Investigators were interviewed about their practice. This study showed that patients with dyskinesias had an earlier onset of the disease (11.2 years vs. 3.7 years). They also had a higher level of disease severity, according to the Hoehn & Yahr scale (40p. cent vs. 0p. cent presenting a level of 4). The mean monthly cost was significantly higher for patients with dyskinesias (FF 3 733 versus FF 1 109, p=0.0005). Particularly, the presence of dyskinesias had a significant impact on treatment costs and medical visits. A positive gradient of the medical cost with level of dyskinesia severity was also underlined. In the same way, the more severe the dyskinesia status the greater the need for caregivers. Finally, based on these results, the total annual medical cost of dyskinesias in France was estimated between 588 and 812 million francs.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">11438770</PMID><DateCreated><Year>2001</Year><Month>07</Month><Day>04</Day></DateCreated><DateCompleted><Year>2001</Year><Month>10</Month><Day>04</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0035-3787</ISSN><JournalIssue CitedMedium="Print"><Volume>157</Volume><Issue>5</Issue><PubDate><Year>2001</Year><Month>May</Month></PubDate></JournalIssue><Title>Revue neurologique</Title><ISOAbbreviation>Rev. Neurol. (Paris)</ISOAbbreviation></Journal><ArticleTitle>[Social and economic cost of L-Dopa-induced dyskinesias in patients with Parkinson's disease].</ArticleTitle><Pagination><MedlinePgn>507-14</MedlinePgn></Pagination><Abstract><AbstractText>Long term L-Dopa medication mainly induces two complications in Parkinson's Disease (PD) patients, i.e. motor fluctuations and dyskinesias. Both of these complications can significantly impair the patient's quality of life. At a high degree of severity, dyskinesias can interfere with everyday tasks, balance, speech, etc. From a clinical point of view, they lead to complicated L-Dopa dose adjustments or to the use of sustained release forms. For these reasons, L-Dopa-induced dyskinesias may have a significant human and financial impact. We have designed a retrospective study to explore two aspects of PD, i.e. the impact of dyskinesias on patient's social life and their economic cost. Ten French neurologists were randomly selected from a national file to participate in this study. They were asked to include 4 patients with PD currently under L-Dopa medication and showing 4 different levels of dyskinesia severity, i.e. absent, moderate, mild and severe dyskinesia, according to the Unified Parkinson Disease Rating Scale, with no other specific inclusion criteria. Two specific scales were to be completed, Hoehn & Yahr on disease severity and Schwab & England on degree of independence. Clinical profiles of patients, demographics and use of medical resources were also recorded. Investigators were interviewed about their practice. This study showed that patients with dyskinesias had an earlier onset of the disease (11.2 years vs. 3.7 years). They also had a higher level of disease severity, according to the Hoehn & Yahr scale (40p. cent vs. 0p. cent presenting a level of 4). The mean monthly cost was significantly higher for patients with dyskinesias (FF 3 733 versus FF 1 109, p=0.0005). Particularly, the presence of dyskinesias had a significant impact on treatment costs and medical visits. A positive gradient of the medical cost with level of dyskinesia severity was also underlined. In the same way, the more severe the dyskinesia status the greater the need for caregivers. Finally, based on these results, the total annual medical cost of dyskinesias in France was estimated between 588 and 812 million francs.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Maurel</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>CLP-Sante, 20, rue de Boulainvilliers, 75016 Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lilliu</LastName><ForeName>H</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Le Pen</LastName><ForeName>C</ForeName><Initials>C</Initials></Author></AuthorList><Language>fre</Language><PublicationTypeList><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Le coût socio-économique des dyskinésies associées au traitement par la L-Dopa chez des patients atteints de maladie de Parkinson.</VernacularTitle></Article><MedlineJournalInfo><Country>France</Country><MedlineTA>Rev Neurol (Paris)</MedlineTA><NlmUniqueID>2984779R</NlmUniqueID><ISSNLinking>0035-3787</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>46627O600J</RegistryNumber><NameOfSubstance UI="D007980">Levodopa</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D017677" MajorTopicYN="N">Age Distribution</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000978" MajorTopicYN="N">Antiparkinson Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004409" MajorTopicYN="N">Dyskinesia, Drug-Induced</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017048" MajorTopicYN="N">Health Care Costs</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007980" MajorTopicYN="N">Levodopa</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017678" MajorTopicYN="N">Sex Distribution</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2001</Year><Month>7</Month><Day>5</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2001</Year><Month>10</Month><Day>5</Day><Hour>10</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2001</Year><Month>7</Month><Day>5</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">11438770</ArticleId><ArticleId IdType="pii">MDOI-RN-05-2001-157-5-0035-3787-101019-ART4</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><noCountry><name sortKey="Le Pen, C" sort="Le Pen, C" uniqKey="Le Pen C" first="C" last="Le Pen">C. Le Pen</name><name sortKey="Lilliu, H" sort="Lilliu, H" uniqKey="Lilliu H" first="H" last="Lilliu">H. Lilliu</name></noCountry><country name="France"><region name="Île-de-France"><name sortKey="Maurel, F" sort="Maurel, F" uniqKey="Maurel F" first="F" last="Maurel">F. Maurel</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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