Format

Send to:

Choose Destination
See comment in PubMed Commons below
Parkinsonism Relat Disord. 2014 Mar;20(3):274-9. doi: 10.1016/j.parkreldis.2013.10.004. Epub 2013 Oct 16.

Mobility, mood and site of care impact health related quality of life in Parkinson's disease.

Author information

  • 1Oregon Health & Science University, USA. Electronic address: nuttj@ohsu.edu.
  • 2University of Pennsylvania, USA.
  • 3University of Toronto, USA.
  • 4National Parkinson Foundation, USA.
  • 5University of Florida, USA.
  • 6National Parkinson Foundation, USA; University of Florida, USA.
  • 7Northwestern University, USA.
  • 8Struthers Parkinson Center, USA.
  • 9Vanderbilt University, USA.
  • 10Tel Aviv Sourasky Medical Center, USA.
  • 11University of South Florida, USA.
  • 12Baylor College of Medicine, USA.
  • 13University of Kansas, USA.
  • 14DeBakey Veterans Affairs Medical Center, USA.
  • 15Toronto Western University, USA.
  • 16Georgia Regents University, USA.
  • 17Muhammad Ali Parkinson Center, USA; Barrow Neurological Institute, USA.
  • 18Beth Israel Medical Center, USA.
  • 19Johns Hopkins Medical Center, USA.
  • 20Dartmouth-Hitchcock Medical Center, USA.

Abstract

OBJECTIVE:

Examine the correlates of Health Related Quality of Life (HRQL) in a large cohort of Parkinson's disease (PD) patients from National Parkinson Foundation (NPF) Centers of Excellence (COEs).

BACKGROUND:

Improving outcomes for PD will depend upon uncovering disease features impacting HRQL to identify targets for intervention and variables for risk-adjustment models. Differences in HRQL outcomes between COEs could uncover modifiable aspects of care delivery.

METHODS:

This cross-sectional study examined the relative contribution of demographic, social, clinical and treatment features potentially related to HRQL, as measured by the PDQ-39, in 4601 consecutive subjects from 18 COEs. Stepwise linear regression was utilized to identify correlates of HRQL.

RESULTS:

The variability in the PDQ-39 summary index score correlated with H&Y stage (R(2) = 22%), Timed up and Go (TUG) (17%), disease duration (11%), comorbidities (8%), cognitive status (8%), antidepressant use (6%) and center at which a patient received care (5%). Stepwise regression reordered the importance of the variables, with the H&Y first and TUG and the center becoming equal and the second most important variables determining the PDQ-39 total score. All independent variables together accounted for 44% of the variability in HRQL.

CONCLUSIONS:

We confirmed many but not all HRQL associations found in smaller studies. A novel observation was that the site of care was an important contributor to HRQL, suggesting that comparison of outcomes and processes among centers may identify best practices.

Copyright © 2013 Elsevier Ltd. All rights reserved.

KEYWORDS:

Best practices; Health related quality of life; Parkinson's disease; Quality improvement

PMID:
24182524
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk