Table 3.
Associations between alternate methods of assigning APD status and clinical indicators of advanced diseasea.
| Levodopa dose >1000 mg/day (n = 24,851) |
Levodopa dose >800 mg/day (n = 39,631) |
LED dose >800 mg/day (n = 43,790) |
|
|---|---|---|---|
| APD indicators | OR (95% CI) | OR (95% CI) | OR (95% CI) |
| Any deep brain stimulationb | 2.96 (2.74–3.19) | 2.47 (2.30–2.66) | 2.41 (2.24–2.59) |
| Fall | 1.24 (1.18–1.30) | 1.23 (1.17–1.30) | 1.26 (1.19–1.33) |
| Hallucinations | 1.71 (1.61–1.82) | 1.63 (1.53–1.73) | 1.74 (1.63–1.86) |
| Walker | 1.58 (1.47–1.71) | 1.54 (1.43–1.67) | 1.61 (1.47–1.75) |
| Wheelchair | 2.02 (1.91–2.13) | 1.93 (1.83–2.04) | 2.00 (1.89–2.13) |
| Specialty bed | 2.11 (1.96–2.27) | 2.04 (1.89–2.19) | 2.09 (1.93–2.27) |
| Dementia | 1.18 (1.15–1.22) | 1.20 (1.16–1.23) | 1.21 (1.17–1.25) |
| Skilled nursing facility | 1.72 (1.39–2.12) | 1.62 (1.30–2.01) | 1.44 (1.12–1.85) |
| Hospice | 1.71 (1.57–1.86) | 1.67 (1.53–1.82) | 1.69 (1.53–1.86) |
APD, Advanced Parkinson's disease; CI, confidence interval; LED, levodopa equivalent dose; OR, odds ratio.
Dosage cutoffs represent various approaches to classifying patients as having APD, based on an algorithm derived from prescription claims. Patients meeting the dose criterion indicated were classified as having advanced disease. Logistic regressions adjusted for sociodemographic characteristics (age, sex, race, region), clinical characteristics (RxHCC score), and treatment characteristics (any outpatient visit with a neurologist during study year). The reference group is those who did not meet the dosage criterion (i.e., those classified as mild-moderate status). All comparisons were significant at the P < 0.001 level, with the exception of skilled nursing facility for the levodopa dose >800 mg group (P < 0.005).
Deep brain stimulation was defined as the presence of any CPT code indicating current or recent treatment (e.g., device placement or programming).