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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00794

Sex-specific patient journeys in early Parkinson’s disease in the Netherlands

 Floris P. Vlaanderen1*, Yvonne de Man1, Jesse H. Krijthe2, Marit A. Tanke1, A. S. Groenewoud1, Patrick P. Jeurissen1, Sabine Oertelt-Prigione1, Marten Munneke1, Bastiaan R. Bloem1 and  Marjan J. Meinders1
  • 1Radboud University Nijmegen Medical Centre, Netherlands
  • 2Radboud University Nijmegen, Netherlands

Abstract

Objective
To reconstruct a sex-specific patient journey for Dutch persons with Parkinson’s disease (PD) during the first five years after diagnosis.
Method
We analyzed a national administrative medical claims database containing data of all patients newly diagnosed with PD between 2012 and 2016 in the Netherlands. We performed time-to-event analysis to identify the moments when patients received care from neurologists, allied healthcare therapists or general practitioners. We also extracted relevant clinical milestones: unexpected hospitalization for PD, pneumonia, orthopedic injuries, nursing home admission and death. Using these data, we constructed the patient journey stratified for sex.
Results
We included claims data of 13,518 men and 8,775 women with newly diagnosed PD in the Netherlands. While we found little difference in neurologist consultations, women visited general practitioners and physiotherapists significantly earlier and more often (all p-values <0.001). After five years, 37.9% (n=3,326) of women had visited an occupational therapist and 18.5% (n=1,623) a speech & language therapist at least once. This was 33.1% (n=4,474) and 23.7% (n=3,204) for men. Approximately two years after diagnosis, PD-related complications (pneumonia, orthopedic injuries and PD-related hospitalization) occurred for the first time (women: 1.8 years; men: 2.3 years), and after five years, 72.9% (n=6,397) of women and 68.7% (n=9,287) of men had experienced at least one.
Discussion
Considering the strengths and limitations of our methods, our findings suggest that women experience complications and access most healthcare services sooner after diagnosis and more frequently than men. The identified sex differences extend the debate about phenotypical differences in PD between men and women.

Keywords: Patient Journey, Parkinson ' s disease, sex difference, Personalised Care, healthcare usage, early Parkinson’s disease

Received: 12 May 2019; Accepted: 10 Jul 2019.

Edited by:

Mayela Rodríguez-Violante, National Institute of Neurology and Neurosurgery (INNN), Mexico

Reviewed by:

Roland Dominic G. Jamora, University of the Philippines Manila, Philippines
Marina Picillo, University of Salerno, Italy  

Copyright: © 2019 Vlaanderen, de Man, Krijthe, Tanke, Groenewoud, Jeurissen, Oertelt-Prigione, Munneke, Bloem and Meinders. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD. Floris P. Vlaanderen, Radboud University Nijmegen Medical Centre, Nijmegen, 6525 GA, Gelderland, Netherlands, floris.vlaanderen@radboudumc.nl