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Caregiver strain in Parkinson's disease: national Parkinson Foundation Quality Initiative study.
Parkinsonism Relat Disord. 2013 Nov; 19(11):975-9.PR

Abstract

BACKGROUND

National Parkinson Foundation Quality Improvement Initiatives (NPF-QII) is the first large scale data-driven initiative in Parkinson's disease (PD) aimed at identifying variables predicting best care models and outcomes.

OBJECTIVE

To determine what measures of PD disability, demographics, and patient quality of life are associated with caregiver strain among caregivers of patients with PD.

METHODS

All PD patients at 18 participating sites are eligible for enrollment into the NPF-QII registry. Dataset includes multidimensional measures of disease severity, health care utilization, PD quality of life questionnaire-39 (PDQ-39) and multidimensional caregiver strain inventory (MCSI). A univariate as well as an adjusted analysis was performed to examine the relationship between caregiver strain and variables of PD disability.

RESULTS

The single best factor associated with high caregiver strain was the PDQ-39 total score (c-statistic of continuous variable = 0.792, p < 0.001) followed by the PDQ-mobility subscore (c = 0.776, p < 0.001). PDQ-39 ≥ 47 was the optimal cut off associated with a high caregiver strain with a sensitivity = 83% and specificity = 64%. A multiple logistic regression model with stepwise selection showed that in addition to PDQ-39 ≥ 47 (OR and 95% confidence interval = 5.1 (3.2, 8.2), the following subject characteristics were associated with high caregiver strain: (model p < 0.001, c = 0.838): Hoehn and Yahr stage >3 (2.0 (1.3, 3.1)), presence of concomitant medications such as antidepressants (2.1 (1.5, 3.1)) and antipsychotics (2.5 (1.5, 4.2)), social worker visits (1.6 (1.2, 2.1)), male gender (2.3 (1.5, 3.5)), and decreased verbal fluency (0.95 (0.92, 0.98)).

CONCLUSIONS

There is a high prevalence of caregiver strain in PD. PDQ-39 total score has the strongest association with high levels of caregiver strain. These results could guide clinicians in the assessment of caregivers at risk.

Authors+Show Affiliations

Department of Neurology, University of Florida, 580 West 8th Street 9th FL, Jacksonville, FL 32209, USA. Electronic address: Odinachi.Oguh@jax.ufl.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23871587

Citation

Oguh, O, et al. "Caregiver Strain in Parkinson's Disease: National Parkinson Foundation Quality Initiative Study." Parkinsonism & Related Disorders, vol. 19, no. 11, 2013, pp. 975-9.
Oguh O, Kwasny M, Carter J, et al. Caregiver strain in Parkinson's disease: national Parkinson Foundation Quality Initiative study. Parkinsonism Relat Disord. 2013;19(11):975-9.
Oguh, O., Kwasny, M., Carter, J., Stell, B., & Simuni, T. (2013). Caregiver strain in Parkinson's disease: national Parkinson Foundation Quality Initiative study. Parkinsonism & Related Disorders, 19(11), 975-9. https://doi.org/10.1016/j.parkreldis.2013.06.015
Oguh O, et al. Caregiver Strain in Parkinson's Disease: National Parkinson Foundation Quality Initiative Study. Parkinsonism Relat Disord. 2013;19(11):975-9. PubMed PMID: 23871587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Caregiver strain in Parkinson's disease: national Parkinson Foundation Quality Initiative study. AU - Oguh,O, AU - Kwasny,M, AU - Carter,J, AU - Stell,B, AU - Simuni,T, Y1 - 2013/07/18/ PY - 2012/08/17/received PY - 2013/05/28/revised PY - 2013/06/25/accepted PY - 2013/7/23/entrez PY - 2013/7/23/pubmed PY - 2014/6/28/medline KW - Caregiver strain KW - Clinical correlates KW - Parkinson's disease KW - Quality of life KW - Questionnaires SP - 975 EP - 9 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 19 IS - 11 N2 - BACKGROUND: National Parkinson Foundation Quality Improvement Initiatives (NPF-QII) is the first large scale data-driven initiative in Parkinson's disease (PD) aimed at identifying variables predicting best care models and outcomes. OBJECTIVE: To determine what measures of PD disability, demographics, and patient quality of life are associated with caregiver strain among caregivers of patients with PD. METHODS: All PD patients at 18 participating sites are eligible for enrollment into the NPF-QII registry. Dataset includes multidimensional measures of disease severity, health care utilization, PD quality of life questionnaire-39 (PDQ-39) and multidimensional caregiver strain inventory (MCSI). A univariate as well as an adjusted analysis was performed to examine the relationship between caregiver strain and variables of PD disability. RESULTS: The single best factor associated with high caregiver strain was the PDQ-39 total score (c-statistic of continuous variable = 0.792, p < 0.001) followed by the PDQ-mobility subscore (c = 0.776, p < 0.001). PDQ-39 ≥ 47 was the optimal cut off associated with a high caregiver strain with a sensitivity = 83% and specificity = 64%. A multiple logistic regression model with stepwise selection showed that in addition to PDQ-39 ≥ 47 (OR and 95% confidence interval = 5.1 (3.2, 8.2), the following subject characteristics were associated with high caregiver strain: (model p < 0.001, c = 0.838): Hoehn and Yahr stage >3 (2.0 (1.3, 3.1)), presence of concomitant medications such as antidepressants (2.1 (1.5, 3.1)) and antipsychotics (2.5 (1.5, 4.2)), social worker visits (1.6 (1.2, 2.1)), male gender (2.3 (1.5, 3.5)), and decreased verbal fluency (0.95 (0.92, 0.98)). CONCLUSIONS: There is a high prevalence of caregiver strain in PD. PDQ-39 total score has the strongest association with high levels of caregiver strain. These results could guide clinicians in the assessment of caregivers at risk. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/23871587/Caregiver_strain_in_Parkinson's_disease:_national_Parkinson_Foundation_Quality_Initiative_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(13)00233-2 DB - PRIME DP - Unbound Medicine ER -