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Abstract Details

Disparities in Access to Care and Research Participation in Advanced Parkinson's Disease: Differences between a Home Visit Study and Outpatient Clinic Population
Movement Disorders
P2 - Poster Session 2 (8:00 AM-9:00 PM)
3-013
To describe sociodemographic differences between individuals with advanced Parkinson’s Disease (PD) still receiving care in an outpatient clinic vs. those enrolled in an interdisciplinary home visit study
Individuals with PD from underrepresented minority backgrounds face disparities in access to expert neurologic care. Such disparities also persist in PD research participation, sometimes attributed to mistrust and stigma. As minority patients become homebound, they become further estranged from care and research representation. We launched an interdisciplinary home visit study to extend continuity of care to homebound individuals with advanced PD. Here, we seek to identify sociodemographic differences between home visit (HV) participants and the outpatient (OP) clinic population from which they were recruited to determine whether disparities in care and research enrollment among minority patients persist with this patient-centered, care-focused intervention. 
Cross-sectional study comparing individuals with advanced PD—Hoehn & Yahr stage >3—drawn from a single movement disorders center between 2017-2019. We conducted a chart review for demographic information and used t-tests or Wilcoxon signed-rank tests as appropriate to assess population differences. 
The HV population is significantly older (n = 58 HV, 1015 OP; mean age 78.4 (SD 7.5) vs. 75.0 (SD 9.2), respectively, p = 0.002) and includes nearly twice the percentage of minority patients (26.3% non-Caucasian vs. 14.7% non-Caucasian in OP, p = 0.02). As expected, HV had worse PD severity, with 62.1% stage 4 and 17.2% stage 5, vs. 28.6% and 11.0% of OP, respectively (p <0.0001).
The proportion of minority patients with advanced PD enrolled in a home-based study is significantly greater than that receiving care in the OP setting. Our results suggest that despite their advanced age and disease, this population is amenable to research participation. Ultimately, continued access to care poses a large but surmountable hurdle to research participation for minority patients.
Authors/Disclosures
Jori Fleisher, MD, MSCE, FÂ鶹´«Ã½Ó³»­ (Rush University Parkinson's and Movement Disorders Program)
PRESENTER 		The institution of Dr. Fleisher has received research support from Parkinson's Foundation. The institution of Dr. Fleisher has received research support from NIH/NINDS. The institution of Dr. Fleisher has received research support from NIH/NINDS. The institution of Dr. Fleisher has received research support from NIA/NINDS. The institution of Dr. Fleisher has received research support from NIA/NINDS. Dr. Fleisher has received publishing royalties from a publication relating to health care. Dr. Fleisher has received personal compensation in the range of $0-$499 for serving as a Speaker with Parkinson's Foundation. Dr. Fleisher has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Lewy Body Dementia Association. Dr. Fleisher has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Davis Phinney Foundation. Dr. Fleisher has a non-compensated relationship as a Editorial Board Member with Â鶹´«Ã½Ó³»­ Brain & Life Magazine that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Bichun Ouyang Bichum Ouyang has nothing to disclose.
Deborah H. Hall, MD, PhD, FÂ鶹´«Ã½Ó³»­ (Rush University) Dr. Hall has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Â鶹´«Ã½Ó³»­. Dr. Hall has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier - Parkinsonism and Related Disorders. Dr. Hall has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of Neurology. The institution of Dr. Hall has received research support from Parkinson's Foundation. The institution of Dr. Hall has received research support from CHDI. The institution of Dr. Hall has received research support from Uniqure. The institution of Dr. Hall has received research support from NIH.
Joshua Chodosh, MD (NYU Langone Health) The institution of Dr. Chodosh has received research support from NIH-NIA. The institution of Dr. Chodosh has received research support from NIH-NINR.