Black and hispanic patients with movement disorders less likely to undergo deep brain stimulation

Dorritie, Andrew; Faysel, Mohammad; Gruessner, Angelika; Robakis, Daphne

doi:10.1016/j.parkreldis.2023.105811

Cited by 4 publications

(8 citation statements)

References 33 publications

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“…Our review revealed that the availability of DBS among Black individuals is lower ( Chan et al, 2014 ; Willis et al, 2014 ; Cramer et al, 2022 ; Dorritie et al, 2023 ; Skelton et al, 2023 ). Table 2 provides details of the included studies.…”

Section: Resultsmentioning

confidence: 95%

“…Similar results were found in a recent study that also queried the NIS database for United States hospitalizations from 2012 to 2018. It revealed that Black patients were less likely to receive DBS, primarily due to insurance and low income ( Dorritie et al, 2023 ).…”

Section: Resultsmentioning

confidence: 99%

“…Surprisingly, white patients utilizing Medicaid received significantly more DBS surgeries than Black patients using private insurance and Medicare, indicating that a distinct combination of Medicaid and race/ethnicity is responsible for the observed access disparity ( Chan et al, 2014 ). Further investigations are warranted to comprehensively understand the relationship between socioeconomic factors, cultural factors, and Medicaid utilization in the context of DBS access ( Eskandar et al, 2003 ; Katz et al, 2011 ; Dorritie et al, 2023 ). Exploring the complex interplay between these factors can provide valuable insights into the mechanisms underlying the DBS disparity among racial minorities and inform the development of targeted strategies to mitigate these disparities.…”

Section: Discussionmentioning

confidence: 99%

“…The small sample sizes in some studies limit the statistical power of the primary outcomes ( Shpiner et al, 2019 ; Deshpande et al, 2022 ; Watanabe et al, 2022 ; Skelton et al, 2023 ). Additionally, using the NIS dataset ( Chan et al, 2014 ; Willis et al, 2014 ; Cramer et al, 2022 ; Dorritie et al, 2023 ), which is retrospective, introduces limitations related to coding accuracy and data completeness. Furthermore, the cross-sectional study designs employed in several studies hinder the systematic assessment of the reasons behind DBS disparities.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review of health disparities research in deep brain stimulation surgery for Parkinson’s disease

Memon,

Gelman,

Melott

et al. 2023

Front. Hum. Neurosci.

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BackgroundDeep brain stimulation (DBS) is the primary surgical intervention for Parkinson’s disease (PD) patients with insufficient response to medication, significantly improving motor symptoms and quality of life. Despite FDA approval for over two decades, access to this therapy remains limited. This systematic review aims to evaluate the influence of gender, race/ethnicity, socioeconomic status, and age on health disparities associated with DBS for PD, providing an overview of current research in this field.MethodsA systematic literature search was conducted in PubMed/MEDLINE, Embase, Web of Science and Cochrane databases from 1960 to September 12th, 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies that examine the disparities in accessing DBS among patients with PD were included, comparing different demographic factors. Findings were synthesized and presented narratively to identify and understand DBS disparities.ResultsAfter screening for relevance, 25 studies published between 1960 and 2023 were included, with 16 studies meeting full-text review criteria. While reviewing the references of the 16 articles, two additional studies were included, bringing the total number of included studies to 18. Most studies originated from the United States (44%). The identified studies were categorized as identifying disparities, understanding disparities, or reducing disparities. The majority focused on identifying disparities (72%), while fewer studies delved into understanding the underlying factors (28%). No studies evaluated strategies for reducing disparities. The findings indicate that elderly, female, and Black people, as well as those from low socioeconomic backgrounds and developing countries face greater obstacles in accessing DBS for PD.ConclusionThis study highlights factors contributing to disparities in DBS utilization for PD, including race, gender, and socioeconomic status. Public health policymakers, practitioners, and clinicians should recognize these inequalities and work toward reducing disparities, particularly among vulnerable populations.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of health disparities research in deep brain stimulation surgery for Parkinson’s disease

Memon,

Gelman,

Melott

et al. 2023

Front. Hum. Neurosci.

View full text Add to dashboard Cite

show abstract

“…One study found that there was no difference in DBS use between white and Hispanic Medicare beneficiaries after adjusting for confounders [ 13 ]. On the other hand, Hispanic patients with PD were found in a separate study to be less likely to undergo DBS when controlling for patient and hospital characteristics [ 37 ]. Given that Hispanic patients are also underrepresented in other neurosurgical procedures such as spine surgery [ 38 ], this is an area important for future study.…”

Section: Resultsmentioning

confidence: 99%

Disparities in Access to Deep Brain Stimulation for Parkinson’s Disease and Proposed Interventions: A Literature Review

Bishay,

Hughes,

Zargari

et al. 2024

Stereotact Funct Neurosurg

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Background: Deep brain stimulation (DBS) is an effective therapy for Parkinson’s disease (PD), but disparities exist in access to DBS along gender, racial, and socioeconomic lines. Summary: Women are underrepresented in clinical trials and less likely to undergo DBS compared to their male counterparts. Racial and ethnic minorities are also less likely to undergo DBS procedures, even when controlling for disease severity and other demographic factors. These disparities can have significant impacts on patients’ access to care, quality of life, and ability to manage their debilitating movement disorders. Key Messages: Addressing these disparities requires increasing patient awareness and education, minimizing barriers to equitable access, and implementing diversity and inclusion initiatives within the healthcare system. In this systematic review, we first review literature discussing gender, racial, and socioeconomic disparities in DBS access and then propose several patient, provider, community, and national-level interventions to improve DBS access for all populations.

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Neuropsychological and social predictors of participation in a deep brain stimulation study of Parkinson’s disease and dystonia

Hahn,

Lazar,

Cernera

et al. 2024

Deep Brain Stimulation

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Black and hispanic patients with movement disorders less likely to undergo deep brain stimulation

Cited by 4 publications

References 33 publications

A systematic review of health disparities research in deep brain stimulation surgery for Parkinson’s disease

A systematic review of health disparities research in deep brain stimulation surgery for Parkinson’s disease

Disparities in Access to Deep Brain Stimulation for Parkinson’s Disease and Proposed Interventions: A Literature Review

Neuropsychological and social predictors of participation in a deep brain stimulation study of Parkinson’s disease and dystonia

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