Parkinsonism and Related Disorders

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 1⁄4 63 subjects), and only 33 (11%) were from the infrequent caller group (n 1⁄4 112 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 1⁄4 0.007). In multivariate logistic regression analysis, independent predictors of frequent calling were: anxiety (STAI 55; adjusted OR 1⁄4 2.62, p 1⁄4 0.02), sleep disorders (adjusted OR 1⁄4 2.36, p 1⁄4 0.02), dyskinesias (adjusted OR 1⁄4 3.07, p 1⁄4 0.03), and dopamine agonist use (adjusted OR 1⁄4 2.27, p 1⁄4 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. 2010 Elsevier Ltd. All rights reserved.