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The impact of motor and non motor symptoms on health state values in newly diagnosed idiopathic Parkinson’s disease

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Abstract

The aim of the study was to estimate health state utility values in newly diagnosed idiopathic Parkinson’s disease (PD) for use in the assessment of health-related quality-of-life (HRQL), and in the estimation of quality-adjusted life-years (QALYs). Data from 162 patients enrolled in a community-based incidence study of PD were used to estimate health state utility values. Self-report data from the EQ-5D, a generic measure of HRQL, were used to derive preference-based health state utility values. The impact of motor and non motor symptoms, and other clinical and demographic factors, on the derived EQ-5D health state values was examined in univariate and multivariate analyses. The mean health state utility value for recently diagnosed PD patients was estimated at 0.65 ± 0.27. Significant reductions in health state values were attributable to pain (−0.18), motor functioning (−0.16), depression (−0.12), and insomnia (−0.11). Depression had its greatest impact (−0.19) in patients in the less severe stages of PD (i.e. Hoehn Yahr stages ≤2.5). This study shows, through the presentation of QALY values, that there is scope to achieve significant health gains in newly diagnosed idiopathic PD patients via improved management of pain, depression and insomnia, alongside the treatment of primary motor symptoms.

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References

  1. Wickremaratchi MM, Perera D, O’Loghlen C et al (2009) Prevalence and age of onset of Parkinson’s disease in Cardiff: a community based cross sectional study and meta-analysis. J Neurol Neurosurg Psychiatry 80:805–807

    Article  PubMed  CAS  Google Scholar 

  2. de Lau L, Breteler M (2006) Epidemiology of Parkinson’s disease. Lancet Neurol 5:525–535

    Article  PubMed  Google Scholar 

  3. Dowding C, Shenton C, Salek S (2006) A review of the health-related quality of life and economic impact of Parkinson’s disease. Drugs Aging 23:693–721

    Article  PubMed  Google Scholar 

  4. Rascol O, Payoux P, Ory F et al (2003) Limitations of current Parkinson’s disease therapy. Ann Neurol 53:S3–S12

    Article  PubMed  CAS  Google Scholar 

  5. Soh S-E, Morris M, McGinley J (2011) Determinants of health-related quality of life in Parkinson’s disease. Parkinsonism Relat Disord 17:1–9

    Article  PubMed  Google Scholar 

  6. Gallagher D, Lees A, Schrag A (2010) What are the most important nonmotor symptoms in patients with Parkinson’s disease and are we missing them? Mov Disord 25:2493–2500

    Article  PubMed  Google Scholar 

  7. Canadian Agency for Drugs and Technologies in Health (2006) Guidelines for the economic evaluation of health technologies. Canadian Agency for Drugs and Technologies in Health, Ottawa

  8. National Institute for Health and Clinical Excellence (2008) Guide to the methods of technology appraisal. National Institute for Health and Clinical Excellence, London

  9. Pharmaceutical Benefits Advisory Committee. Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee. Barton: Australian Government Department of Health and Ageing; 2008

  10. Dorsey E, Meltzer D (2010) The economics of comparative effectiveness research. Neurology 75:492–493

    Article  Google Scholar 

  11. Caslake R, Moore J, Gordon J et al (2008) Changes in diagnosis with follow-up in an incident cohort of patients with Parkinsonism. J Neurol Neurosurg Psychiatry 79:1202–1207

    Article  PubMed  CAS  Google Scholar 

  12. Taylor K, Counsell C, Harris C et al (2006) Pilot study of the incidence and prognosis of degenerative Parkisonian disorders in Aberdeen, United Kingdom: methods and preliminary results. Mov Disord 21:976–982

    Article  PubMed  Google Scholar 

  13. Fahn S, Elton R (1987) UPDRS Development Committee. The Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden C, Goldstein M, Calne D (eds) Recent developments in Parkinson’s disease. vol 2. Macmillan Healtcare Information, Florham Park, NJ, 153–163

  14. Goetz C, Poewe W, Rascol O et al (2004) Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson’s disease. Mov Disord 19:1020–1028

    Article  PubMed  Google Scholar 

  15. Folstein M, Folstein S, McHugh P (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  PubMed  CAS  Google Scholar 

  16. Mahieux F, Michelet D, Manifacier M-E et al (1995) Mini-mental Parkinson: First validation of a new bedside test constructed for Parkinson’s disease. Behav Neurol 8:15–22

    Google Scholar 

  17. Weintraub D, Oehlberg K, Katz I et al (2006) Test characteristics of the 15-item geriatric depression scale and Hamilton depression rating scale in Parkinson disease. Am J Geriatr Psychiatry 14:169–175

    Article  PubMed  Google Scholar 

  18. Wade D, Collin C (1988) The Barthel ADL Index: A standard measure of physical disability? Int Disabil Stud. 10:64–67

    Article  PubMed  CAS  Google Scholar 

  19. Brooks R, Group TE (1996) EuroQol: the current state of play. Health Policy 37:53–72

    Article  PubMed  CAS  Google Scholar 

  20. Schrag A, Selai C, Jahanshahi M et al (2000) The EQ-5D––a generic quality of life measure––is a useful instrument to measure quality of life in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 69:67–73

    Article  PubMed  CAS  Google Scholar 

  21. Dolan P (1997) Modeling Valuations for EuroQol Health States. Med Care 35:1095–1108

    Article  PubMed  CAS  Google Scholar 

  22. Schrag A, Jahanshahi M, Quinn N (2000) How does Parkinson’s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord 15:1112–1118

    Article  PubMed  CAS  Google Scholar 

  23. Siderowf A, Ravina B, Glick H (2002) Preference-based quality-of-life in patients with Parkinson’s disease. Neurology 59:103–108

    PubMed  Google Scholar 

  24. Reuther M, Spottke E, Klotsche J et al (2007) Assessing health-related quality of life in patients with Parkinson’s disease in a prospective longitudinal study. Parkinsonism Relat Disord 13:108–114

    Article  PubMed  CAS  Google Scholar 

  25. Vossius C, Nilsen OB, Larsen JP (2009) Health state values during the first year of drug treatment in early-stage Parkinson’s disease: a prospective, population-based, cohort study. Drugs Aging 26:973–980

    Article  PubMed  Google Scholar 

  26. Rahman S, Griffin H, Quinn N et al (2008) Quality of life in Parkinson’s disease: the relative importance of the symptoms. Mov Disord 23:1428–1434

    Article  PubMed  Google Scholar 

  27. Roh JH, Kim BJ, Jang JH et al (2009) The relationship of pain and health-related quality of life in Korean patients with Parkinson’s disease. Acta Neurol Scand 119:397–403

    Article  PubMed  CAS  Google Scholar 

  28. Lee M, Walker R, Hildreth T et al (2006) A survey of pain in idiopathic Parkinson’s disease. J Pain Symptom Manag 32:462–469

    Article  Google Scholar 

  29. Beiske AG, Loge JH, Ronningen A et al (2009) Pain in Parkinson’s disease: Prevalence and characteristics. Pain Jan 141:173–177

    CAS  Google Scholar 

  30. Forsaa E, Larsen J, Wentzel-Larsen T et al (2008) Predictors and course of health-related quality of life in Parkinson’s disease. Mov Disord 23:1420–1427

    Article  PubMed  Google Scholar 

  31. Qin Z, Zhang L, Sun F et al (2009) Health related quality of life in early Parkinson’s disease: impact of motor and non-motor symptoms, results from Chinese levodopa exposed cohort. Parkinsonism Relat Disord 15:767–771

    Article  PubMed  Google Scholar 

  32. Li H, Zhang M, Chen L et al (2010) Nonmotor symptoms are independently associated with impaired health-related quality of life in Chinese patients with Parkinson’s disease. Mov Disord 25:2740–2746

    Article  PubMed  Google Scholar 

  33. Schrag A (2006) Quality of life and depression in Parkinson’s disease. J Neurol Sci 248:151–157

    Article  PubMed  Google Scholar 

  34. Chaudhuri KR, Martinez-Martin P, Brown RG et al (2007) The metric properties of a novel non-motor symptoms scale for Parkinson’s disease: results from an international pilot study. Mov Disord 22:1901–1911

    Article  PubMed  Google Scholar 

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Acknowledgments

This report/article presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0707-10124). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Colin Green received support in part from the NIHR through the Peninsula Collaboration for Leadership in Applied Health Research and Care. The PINE study was funded by Parkinson’s UK and the BMA Doris Hiller Award. The authors have no competing interests. We would like to acknowledge input and helpful comments concerning the statistical analysis from Dr Paul Thompson, University of Plymouth. We thank all the participants in the PINE study.

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Authors and Affiliations

  1. Health Economics Group, Peninsula College of Medicine and Dentistry, University of Exeter, Veysey Building, Salmon Pool Lane, Exeter, EX2 4SG, UK

    James Shearer & Colin Green

  2. Peninsula Collaboration for Leadership in Applied Health Research and Care, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK

    Colin Green

  3. Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK

    Carl E. Counsell

  4. Clinical Neurosciences Research Group, Peninsula College of Medicine and Dentistry, University of Plymouth, Plymouth, UK

    John P. Zajicek

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  1. James Shearer
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  2. Colin Green
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  3. Carl E. Counsell
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  4. John P. Zajicek
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Correspondence to James Shearer.

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Shearer, J., Green, C., Counsell, C.E. et al. The impact of motor and non motor symptoms on health state values in newly diagnosed idiopathic Parkinson’s disease. J Neurol 259, 462–468 (2012). https://doi.org/10.1007/s00415-011-6202-y

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  • DOI: https://doi.org/10.1007/s00415-011-6202-y

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