Increasing trends in utilization of physical and occupational therapy services in early Parkinson's disease.

Abstract

Background: Best practice guidelines in Parkinson's disease (PD) calls for the immediate initiation of rehabilitation therapies (inclusive of physical (PT) and occupational therapy (OT)) to prevent or ameliorate the loss of function and quality of life associated with disease progression.

Objective: The purpose of this study was to determine the utilization of PT and OT services within the first 2 years following PD diagnosis and to observe longitudinal trends in PT and OT utilization early following PD diagnosis.

Methods: This retrospective cohort study accessed 12 years (2011 to 2023) of data from electronic health records at a midwestern US healthy system. Patients with new PD diagnoses and two-years of visit history were included. The primary outcome was utilization of PT or OT services within two-years of PD diagnosis. Data extracted included demographics and PD therapies. Records of 9720 patients were included in the analyses.

Results: Overall, 36.9% of the cohort (n = 3586) received either physical or occupational therapy within two years of receipt of PD diagnosis. Increasing age, higher comorbidity index, female gender, use of dopamine replacement therapies, and African American race were all positively associated with receipt of PT or OT services (ps < 0.007). The longitudinal trend revealed an average year over year increase in PT/OT utilization of 1.4% between 2013 and 2021 (p < 0.001).

Conclusions: This study shows a promising increase in utilization of PT and OT services over previous reports and longitudinally, however it continues to convey how far clinical practice continues to lag behind best practice and scientific recommendation.