Article

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. METHOD: 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). RESULTS: 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%). CONCLUSION: 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.
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Langue : ANGLAIS