Background: Many countries have implemented drastic measures to fight the COVID-19 pandemic. Restrictions and diversion of resources may have negatively affected patients with Parkinson's disease (PD). Our aim was to examine whether COVID-19 had an impact on access to PD medication by region and income. Methods: This study was conducted as part of a survey sent to members of the Movement Disorders Society focusing on access to PD medication globally. Results: Of 346 responses, 157 (45.4%) agreed that COVID-19 had affected access to PD medication, while 189 (54.6%) disagreed. 22.8% of high-income and 88.9% of low-income countries' respondents agreed that access to PD medication was affected by COVID-19. 59% of all 'yes' respondents reported increased disability of patients as an impact. Conclusions: Access to PD medication is likely to have been affected by COVID-19 and result in deterioration of patients' symptomatic control. Resource-poor countries appear to be disproportionately affected compared to more affluent countries.
Background: Parkinson’s disease (PD) is a debilitating neurodegenerative disease with both motor and non-motor manifestations. The mainstay of available treatment reduces symptoms and is critical for improving quality of life. Treatment options include drugs, device-aided therapies, and non-pharmacological therapies. Complementary and alternative therapies (CATs) are also used in some countries. Objective: To examine the availability of PD treatment by country, and differences by national income as defined by the World Bank (high income countries (HICs), upper middle income countries (UMICs), lower middle income countries (LMICs) and low income countries (LICs)). Methods: This study was conducted by surveying International Parkinson and Movement Disorders Society members about availability of PD treatment. LMICs and LICs (LMICs/LICs) were analysed together. Results: There were 352 valid responses from 76 countries (41.5% from HICs, 30.4% from UMICs, and 28.1% from LMICs/LICs). Levodopa was widely available across all income groups (99%). Availability of other PD drugs decreased with national income. Availability of device-aided therapies decreased with national income (100% availability in HICs, 92.5% among UMICs, and 57.6% among LMICs/LICs). A similar trend was observed for CATs (37.0% availability in HICs, 31.8% in UMICs, and 19.2% in LMIC/LICs). Physiotherapy was the most available non-pharmacological therapy (> 90% respondents). Occupational therapy and SALT were less available in LMIC/LICs (49.5% and 55.6% respectively) compared to HICs (80.1% and 84.9%). Conclusion: Our survey highlights significant discrepancies in availability of PD treatments between countries and income groups. This is concerning given the symptomatic benefit patients gain from treatment. Improving equitable access to PD treatment should be prioritised.
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