Clinical and economic analysis of spa therapy in Parkinson's disease

Authors

  • Christine Brefel-Courbon MD,

    Corresponding author
    1. Service de Pharmacologie Clinique and Service d'Hydrologie et de Climatologie Médicales, Laboratoire de Médecine Thermale, University Hospital, Toulouse, France
    • Service de Pharmacologie Médicale et Clinique, Faculté de Medecine, 37 allées Jules Guesde, 31073 Toulouse Cedex, France
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  • Karine Desboeuf MD,

    1. Service de Pharmacologie Clinique and Service d'Hydrologie et de Climatologie Médicales, Laboratoire de Médecine Thermale, University Hospital, Toulouse, France
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  • Claire Thalamas MD,

    1. Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France
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  • Monique Galitzky MD,

    1. Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France
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  • Jean-Michel Senard MD, PhD,

    1. Service de Pharmacologie Clinique and Service d'Hydrologie et de Climatologie Médicales, Laboratoire de Médecine Thermale, University Hospital, Toulouse, France
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  • Olivier Rascol MD, PhD,

    1. Service de Pharmacologie Clinique and Service d'Hydrologie et de Climatologie Médicales, Laboratoire de Médecine Thermale, University Hospital, Toulouse, France
    2. Centre d'Investigation Clinique, Purpan Hospital, Toulouse, France
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  • Jean-Louis Montastruc MD, PhD

    1. Service de Pharmacologie Clinique and Service d'Hydrologie et de Climatologie Médicales, Laboratoire de Médecine Thermale, University Hospital, Toulouse, France
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Abstract

The effectiveness of spa therapy in the management of patients with Parkinson's disease (PD) has never been evaluated. This is assessed in this pilot study. A prospective, randomized, cross-over, controlled study was conducted in 31 PD patients who underwent a 20-week spa period, including spa therapy for 3 weeks, and a 20-week non-spa period. Effectiveness was assessed using quality of life scales (PDQ-39 and SF-36), motor scale (UPDRS) and psychological questionnaire (GHQ-28), at baseline and at 4 (T4) and at 20 weeks (T20). Direct medical costs (radiological and laboratory tests, physician fees, drug therapy, and ancillary care) were recorded over each 20-week period. At T4, spa therapy improved significantly several dimensions of PDQ-39 and SF-36, part IV of the UPDRS, and GHQ-28. At T20, no difference in any parameter was found. The mean direct medical cost over 20 weeks (€1,328 ± 167; £776 ± 97 per patient) in the spa period was slightly but significantly reduced in comparison with that of the non-spa period (€1380 ± 523; £807 ± 306 per patient). This cost-effectiveness analysis suggests that spa therapy is more effective and less expensive than conventional treatment alone and could be beneficial in the management of PD.

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