Descriptive study of the parkinsonian population in the north of France: Epidemiological analysis and healthcare consumption

The “neurodegenerative diseases plan” under elaboration for the Hauts-de-France region requires better knowledge of the patient population and care pathways. In France, the prevalence of Parkinson's disease (PD) has been estimated from cohorts to be about 1–3 per 1000 inhabitants, but exhaustiv...

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Bibliographic Details
Published in:Revue neurologique 2017-06, Vol.173 (6), p.396-405
Main Authors: Carriere, N., Verloop, D., Dupont, C., Fontaine, V., Tir, M., Krystkowiak, P., Blanchard, A., Defebvre, M.-M., Defebvre, L.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antipsychotic Agents - economics
Antipsychotic Agents - therapeutic use
Care consumption
Databases, Factual - statistics & numerical data
Epidemiology
Female
France - epidemiology
Health Resources - statistics & numerical data
Hospitalization - statistics & numerical data
Hospitals - statistics & numerical data
Humans
Insurance fund reimbursement
Insurance, Health, Reimbursement - statistics & numerical data
Male
Middle Aged
Parkinson Disease - economics
Parkinson Disease - epidemiology
Parkinson Disease - therapy
Parkinson's disease
Prevalence
Young Adult
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Summary:The “neurodegenerative diseases plan” under elaboration for the Hauts-de-France region requires better knowledge of the patient population and care pathways. In France, the prevalence of Parkinson's disease (PD) has been estimated from cohorts to be about 1–3 per 1000 inhabitants, but exhaustive data are scarce for the general population. The purpose of this study was to evaluate the prevalence of PD in the Hauts-de-France region and to assess PD-related healthcare consumption. A descriptive study was conducted to identify the parkinsonian population in the Hauts-de-France region (including the administrative districts of Pas-de-Calais and Picardie) for the year 2014. Parkinsonian patients were identified from health insurance fund reimbursement data using the following criteria: (i) reimbursement for a PD-specific medication; (ii) attribution of long-duration disease status coded as PD; (iii) hospital stay with PD diagnosis in the standard discharge report contained in the French medico-economic database on hospital activity (PMSI). The raw prevalence of PD in the region was 5.03 per 1000 inhabitants aged 20 years and older. The standardized prevalence by health territory ranged from 4.0 to 9.0 per 1000 inhabitants aged 20 years and older. During the 1-year study period, 33.5% of patients had a neurology consultation, 57.1% attended a physiotherapy session, and 7.7% received speech therapy. Most of patients (79.6%) were treated with levodopa, sometimes in combination with a catechol-O-methyl transferase inhibitor (14.4%). Dopaminergic agonists were prescribed in 33.5% of cases. A neuroleptic was prescribed for 6.9% of the population (clozapine for 25.9%). The prevalence of PD is high in the Hauts-de-France region with a heterogeneous distribution by health territory. Neurology consultations were attended by a minority of patients in 2014. This work provides perspectives for necessary improvement in specialized care for this disease, both in terms of follow-up consultations and home care.
ISSN:0035-3787
DOI:10.1016/j.neurol.2017.03.036