Clinical predictors of frequent patient telephone calls in Parkinson's disease

Parkinsonism Relat Disord. 2011 Feb;17(2):95-9. doi: 10.1016/j.parkreldis.2010.10.014. Epub 2010 Nov 27.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anxiety / etiology
  • Anxiety / psychology
  • Anxiety / therapy
  • Cohort Studies
  • Female
  • Hotlines / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / complications
  • Parkinson Disease / psychology*
  • Parkinson Disease / therapy*
  • Predictive Value of Tests
  • Prospective Studies
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / psychology
  • Sleep Wake Disorders / therapy
  • Time Factors