Carriere N, Verloop D, Dupont C, Fontaine V, Tir M, Krystkowiak P, Blanchard A, Defebvre M-M, Defebvre L
Service de neurologie et Pathologie du Mouvement, Centre Expert Parkinson, CHRU, 59037 Lille Cedex, France.
ARS hauts de France, 556 Avenue Willybrandt, 59777 EuraLille, France.
Rev Neurol (Paris). 2017 Jun;173(6):396-405. doi: 10.1016/j.neurol.2017.03.036. Epub 2017 May 8.
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.
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).
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%).
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.
法国北部大区正在制定的“神经退行性疾病计划”要求更好地了解患者群体和护理途径。在法国，帕金森病（PD）的患病率经队列研究估计约为每1000名居民中有1 - 3例，但普通人群的详尽数据稀缺。本研究的目的是评估法国北部大区帕金森病的患病率，并评估与帕金森病相关的医疗保健消费情况。
开展一项描述性研究，以确定2014年法国北部大区（包括加来海峡省和皮卡第大区行政区）的帕金森病患者群体。使用以下标准从医疗保险基金报销数据中识别帕金森病患者：（i）特定帕金森病药物的报销；（ii）归类为帕金森病的长期疾病状态；（iii）法国医院活动医疗经济数据库（PMSI）标准出院报告中诊断为帕金森病的住院情况。
该地区20岁及以上居民中帕金森病的粗患病率为每1000人中有5.03例。按健康区域标准化后的患病率为每1000名20岁及以上居民中4.0至9.0例。在1年的研究期间，33.5%的患者进行了神经科会诊，57.1%的患者接受了物理治疗，7.7%的患者接受了言语治疗。大多数患者（79.6%）接受左旋多巴治疗，有时联合儿茶酚 - O - 甲基转移酶抑制剂（14.4%）。33.5%的病例开具了多巴胺能激动剂。6.9%的人群开具了抗精神病药物（氯氮平占25.9%）。
法国北部大区帕金森病患病率较高，且按健康区域分布不均。2C14年少数患者进行了神经科会诊。这项工作为该病专科护理在随访会诊和家庭护理方面的必要改进提供了思路。
