Disparities in access to treatment in relation to quality of life in people diagnosed with Parkinson’s disease

Abstract

The purpose of this study was to compare the treatment received and the perceived efficacy thereof to manage motor and non-motor symptoms of Parkinson’s Disease (PD) between patients who attended either public or private healthcare facilities. The study also examined Quality of Life (QoL) outcomes and its relationship with treatment received, and explored the extent to which sociodemographic variables of household income and internet access moderated the strength and direction of this relationship. Responses to a crosssectional questionnaire assessing demographic variables and QoL from 80 people with Parkinson’s Disease (PwPD) across both healthcare settings in Johannesburg were analyzed using descriptive and correlational statistics, as well as a factorial ANOVA model. Results from this study suggest that PwPD at the private healthcare facility who are members of medical aid schemes have greater access to treatment and higher QoL outcomes than PwPD who received treatment at the public hospital. The study also found that PwPD at public hospitals, of whom the majority use only pharmacological treatment without adjunct therapies, perceive their treatment to be more efficacious than those in the private healthcare facility. Analysis of individual facets of QoL which included Environmental, Physical, Psychological and Social Relationship dimensions revealed that PwPD across both healthcare settings performed the worst in the Psychological domain pertaining to selfesteem, life enjoyment, concentration, acceptance of bodily appearance, having negative feelings and the extent to which they felt their lives to be meaningful. A significant positive moderate relationship was found between treatment and QoL outcomes, where medication with adjunct treatment led to a higher QoL. Household income and internet access did not moderate the relationship between treatment and QoL, however household income was found to be a significant predictor of QoL. Implications of these findings are discussed and recommendations for future research proposed.