Care of PD patients with dementia in office-based neurologists: a national Survey (GEPAD study)

Background: Data related to drug related costs and non-drug related costs in pa-tients with PD is scarce, mainly due to difficulty in data acquisition and the difficulty to obtain these in experimental designs. Likewise the reported impact of drug costs on the position of total direct costs varies across different studies from 20% in European investigations up to more than two thirds in a Chinese study. We therefore conducted the first study with PD patients with dementia in Germany.

Methods: A sample of office-based neurologists in Germany was asked to examine consecutively up to five patients with parkinsonian syndromes on a specified day dur-ing the study period September/October 2005. Patients of all age were eligible. Evaluation of patients was done with standardised questionnaires, acquiring socio-economic data, data on PD and also on neuropsychiatric symptoms. Furthermore, current medication had to be obtained.

Results: PD specific therapy costs increase with stage of disease, onset of disease and disease duration. Dementia is most expensive in its early stages and less in more advanced stages. When analysing data on dementia, depression and concomi-tant treatment, we were able to detect that less then half of all patients with depres-sive symptoms received medical treatment. This was especially true in the more ad-vanced stages, where medication is a hallmark of therapy. Also, other treatment such as psychotherapy was applied in a negligible number of patients.

Conclusion: We describe here first data from a national outpatient study with PD patients and dementia to evaluate treatment costs. A substantial undertreatment of depression in the study sample was observed. In addition, the influence of neuropsy-chiatric symptoms on therapy costs was evaluated. Here we could show that mild depression correlated with higher therapy costs.