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Mobility, mood and site of care impact health related quality of life in Parkinson's disease.
Parkinsonism Relat Disord. 2014 Mar; 20(3):274-9.PR

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.

Authors+Show Affiliations

Oregon Health & Science University, USA. Electronic address: nuttj@ohsu.edu.University of Pennsylvania, USA.University of Toronto, USA.National Parkinson Foundation, USA.National Parkinson Foundation, USA.University of Florida, USA.National Parkinson Foundation, USA; University of Florida, USA.Northwestern University, USA.Struthers Parkinson Center, USA.University of Pennsylvania, USA.Vanderbilt University, USA.Tel Aviv Sourasky Medical Center, USA.Tel Aviv Sourasky Medical Center, USA.University of South Florida, USA.Baylor College of Medicine, USA.University of Kansas, USA.DeBakey Veterans Affairs Medical Center, USA.Toronto Western University, USA.Georgia Regents University, USA.Muhammad Ali Parkinson Center, USA; Barrow Neurological Institute, USA.Beth Israel Medical Center, USA.Johns Hopkins Medical Center, USA.University of Florida, USA.Dartmouth-Hitchcock Medical Center, USA.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24182524

Citation

Nutt, J G., et al. "Mobility, Mood and Site of Care Impact Health Related Quality of Life in Parkinson's Disease." Parkinsonism & Related Disorders, vol. 20, no. 3, 2014, pp. 274-9.
Nutt JG, Siderowf AD, Guttman M, et al. Mobility, mood and site of care impact health related quality of life in Parkinson's disease. Parkinsonism Relat Disord. 2014;20(3):274-9.
Nutt, J. G., Siderowf, A. D., Guttman, M., Schmidt, P. N., Zamudio, J. I., Wu, S. S., Okun, M. S., Simuni, T., Parashos, S. A., Dahodwala, N. A., Davis, T. L., Giladi, N., Gurevich, T., Hauser, R. A., Jankovic, J., Lyons, K. E., Marsh, L., Miyasaki, J. M., Morgan, J. C., ... Nelson, E. C. (2014). Mobility, mood and site of care impact health related quality of life in Parkinson's disease. Parkinsonism & Related Disorders, 20(3), 274-9. https://doi.org/10.1016/j.parkreldis.2013.10.004
Nutt JG, et al. Mobility, Mood and Site of Care Impact Health Related Quality of Life in Parkinson's Disease. Parkinsonism Relat Disord. 2014;20(3):274-9. PubMed PMID: 24182524.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mobility, mood and site of care impact health related quality of life in Parkinson's disease. AU - Nutt,J G, AU - Siderowf,A D, AU - Guttman,M, AU - Schmidt,P N, AU - Zamudio,J I, AU - Wu,S S, AU - Okun,M S, AU - Simuni,T, AU - Parashos,S A, AU - Dahodwala,N A, AU - Davis,T L, AU - Giladi,N, AU - Gurevich,T, AU - Hauser,R A, AU - Jankovic,J, AU - Lyons,K E, AU - Marsh,L, AU - Miyasaki,J M, AU - Morgan,J C, AU - Santiago,A J, AU - Tarsy,D, AU - Mari,Z, AU - Malaty,I A, AU - Nelson,E C, AU - ,, Y1 - 2013/10/16/ PY - 2013/07/30/received PY - 2013/10/04/revised PY - 2013/10/08/accepted PY - 2013/11/5/entrez PY - 2013/11/5/pubmed PY - 2014/12/15/medline KW - Best practices KW - Health related quality of life KW - Parkinson's disease KW - Quality improvement SP - 274 EP - 9 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 20 IS - 3 N2 - 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. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/24182524/Mobility_mood_and_site_of_care_impact_health_related_quality_of_life_in_Parkinson's_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(13)00359-3 DB - PRIME DP - Unbound Medicine ER -