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 (R2=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.
Original language | English (US) |
---|---|
Pages (from-to) | 274-279 |
Number of pages | 6 |
Journal | Parkinsonism and Related Disorders |
Volume | 20 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2014 |
Keywords
- Best practices
- Health related quality of life
- Parkinson's disease
- Quality improvement
ASJC Scopus subject areas
- Neurology
- Geriatrics and Gerontology
- Clinical Neurology