Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

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).
Citation:

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.

This Week's Must Reads

Guidelines for Cognitive Screening, Management of MS, Mult Scler; ePub 2018 Oct 10; Kalb, Beier, et al

Age a Critical Determent in MS Relapse Recovery, Mult Scler; ePub 2018 Oct 10; Conway, et al

Is Contrast MR Imaging Necessary for All Patients?, Am J Neuroradiol; ePub 2018 Oct 4; Mattay, et al

Link Between Physiological and Perceived Fall Risk, Arch Phys Med Rehab; 2018 Oct; Gunn, et al

Muscle Strength Key in Determining Gait Speed in MS, Mult Scler Relat Disord; ePub 2018 Oct 9; Yang, et al

Must Reads in Mixed Topics

Gout Linked with 2-Fold Higher Risk of Sleep Apnea, J Clin Sleep Med; ePub 2018 Aug 30; Singh, Cleveland

Depression, Suicidality Among People with Epilepsy, Epilepsy Behav; ePub 2018 Aug 13; Friedman, et al

Link Found Between Ophthalmic Conditions, AD Risk, Alzheimers Dement; ePub 2018 Aug 8; Lee, et al

Spatial Heterogeneity of White Matter Lesions , Neurology; ePub 2018 Aug 3; Habes, et al

Admissions for Psychotic Episodes, Epilepsy Linked , Epilepsia; ePub 2018 Jul 4; Rossi, Kim, et al