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Orthostatic Hypotension in PD Increases Care Costs

Parkinsonism Relat Disord; ePub 2017 Nov 27; Merola, et al

Orthostatic hypotension (OH) increases health care utilization in Parkinson disease (PD) independently from age, disease duration, motor severity, dopaminergic treatment, and cognitive function, a recent study found. Researchers quantified the emergency room (ER) visits, hospitalizations, outpatient clinic evaluations, phone calls, and e-mails from PD patients on whom supine and orthostatic blood pressure (BP) measurements were obtained during routine clinical practice between June 2013 and July 2016. Comparative costs between PDOH+ and PDOH− were adjusted for age, disease duration, motor severity, levodopa equivalent daily dose, and Montreal Cognitive Assessment. They found:

  • From a total of 317 PD patients, 29.3% were classified as PDOH+ (n=93) and 70.6% as PDOH− (n=224) over 30.2 ± 11.0 months, in which there were 247 hospitalizations, 170 ER visits, 2,386 outpatient evaluations, and 4,747 telephone calls/e-mails.
  • After-adjusting for relevant covariates, PDOH+ was associated with more hospitalization days (+285%), ER visits (+152%), and telephone calls/e-mails than PDOH− (+142%).
  • The overall health care-related cost in PDOH+ was 2.5-fold higher than for PDOH− ($25,205 ± $6,546 vs $9,831 ± $4,167/person/year).

Merola A, Sawyer RP, Artusi CA, et al. Orthostatic hypotension in Parkinson disease: Impact on health care utilization. [Published online ahead of print November 27, 2017]. Parkinsonism Relat Disord. doi:10.1016/j.parkreldis.2017.11.344.