TY - JOUR
T1 - Clinical predictors of frequent patient telephone calls in Parkinson's disease
AU - Liu, Anli A.
AU - Boxhorn, Christine E.
AU - Klufas, Michael A.
AU - Christos, Paul J.
AU - Thorne, Jeffrey T.
AU - Shih, Angela Y.
AU - Tsankova, Nadejda M.
AU - Dorfman, Benjamin J.
AU - Henchcliffe, Claire
AU - Piboolnurak, Panida
AU - Nirenberg, Melissa J.
N1 - Funding Information:
We thank Malinka Velcheva and Bill Nikolov for technical assistance. This study was supported by the Parkinson’s Disease Foundation . Dr. Paul J. Christos was partially supported by the Weill Cornell Clinical Translational Science Center ( UL1-RR024996 ).
PY - 2011/2
Y1 - 2011/2
N2 - Background: Patient telephone calls are a major form of unreimbursed healthcare utilization in Parkinson's disease (PD), yet little is known about potential risk factors for frequent calling behavior. Methods: Prospective cohort study of 175 non-demented outpatients with PD. Our primary outcome measure was the frequency of patient telephone calls over a three-month period relative to baseline demographics, State-Trait Anxiety Index (STAI) and Beck Anxiety Inventory (BAI) scores, Unified Parkinson's Disease Rating Scale (UPDRS) motor scores, and medication use. Based on the median call rate (1 call/3 months), subjects were dichotomized into frequent (≥2 calls) and infrequent (≤1 call) caller groups. Results: A total of 297 calls were received, of which 264 (89%) were from the frequent caller group (n=63 subjects), and only 33 (11%) were from the infrequent caller group (n=112 subjects). Compared with calls from infrequent callers, those from frequent callers more commonly related to somatic symptoms of PD (46.8% vs. 19.4%, p=0.007). In multivariate logistic regression analysis, independent predictors of frequent calling were: anxiety (STAI ≥55; adjusted OR=2.62, p=0.02), sleep disorders (adjusted OR=2.36, p=0.02), dyskinesias (adjusted OR=3.07, p=0.03), and dopamine agonist use (adjusted OR=2.27, p=0.03). Baseline demographics, UPDRS motor scores, and levodopa use were similar in both groups. Conclusions: Frequent patient telephone calls in PD are independently associated with anxiety, sleep disorders, dyskinesias, and dopamine agonist use, with a minority of patients accounting for the majority of calls. Aggressive treatment of these non-motor symptoms and motor complications might potentially reduce the burden of patient telephone calls in PD.
AB - Background: Patient telephone calls are a major form of unreimbursed healthcare utilization in Parkinson's disease (PD), yet little is known about potential risk factors for frequent calling behavior. Methods: Prospective cohort study of 175 non-demented outpatients with PD. Our primary outcome measure was the frequency of patient telephone calls over a three-month period relative to baseline demographics, State-Trait Anxiety Index (STAI) and Beck Anxiety Inventory (BAI) scores, Unified Parkinson's Disease Rating Scale (UPDRS) motor scores, and medication use. Based on the median call rate (1 call/3 months), subjects were dichotomized into frequent (≥2 calls) and infrequent (≤1 call) caller groups. Results: A total of 297 calls were received, of which 264 (89%) were from the frequent caller group (n=63 subjects), and only 33 (11%) were from the infrequent caller group (n=112 subjects). Compared with calls from infrequent callers, those from frequent callers more commonly related to somatic symptoms of PD (46.8% vs. 19.4%, p=0.007). In multivariate logistic regression analysis, independent predictors of frequent calling were: anxiety (STAI ≥55; adjusted OR=2.62, p=0.02), sleep disorders (adjusted OR=2.36, p=0.02), dyskinesias (adjusted OR=3.07, p=0.03), and dopamine agonist use (adjusted OR=2.27, p=0.03). Baseline demographics, UPDRS motor scores, and levodopa use were similar in both groups. Conclusions: Frequent patient telephone calls in PD are independently associated with anxiety, sleep disorders, dyskinesias, and dopamine agonist use, with a minority of patients accounting for the majority of calls. Aggressive treatment of these non-motor symptoms and motor complications might potentially reduce the burden of patient telephone calls in PD.
KW - Anxiety
KW - Dopamine agonist
KW - Healthcare
KW - Motor complications
KW - Non-motor
KW - Parkinson's disease
KW - Quality of care
KW - Resource
KW - Sleep disorder
KW - Telephone
KW - Utilization
UR - http://www.scopus.com/inward/record.url?scp=79551477886&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2010.10.014
DO - 10.1016/j.parkreldis.2010.10.014
M3 - Article
C2 - 21112806
AN - SCOPUS:79551477886
SN - 1353-8020
VL - 17
SP - 95
EP - 99
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
IS - 2
ER -