Category: Surgical Therapy: Parkinson's Disease
Objective: To study the disparities in gender and ethnicity and the related contributing factors in Parkinson’s disease (PD) patients who require deep brain stimulation (DBS), and to implant strategies to address patient-identified barriers and system biases and barriers to improve access to DBS with equality.
Background: DBS is an efficacious, safe, and well-established treatment for PD in carefully selected patients when medical treatment alone cannot manage the disabling symptoms adequately. DBS improves health-related quality of life. Nonetheless, DBS may be underused in certain patient populations, particularly in women and ethnic groups. Barriers to receiving DBS that could account for underuse amongst different gender and ethnicities has not been well investigated in Canada which has a public healthcare system. Comparing the gender and ethnicity of patients who underwent DBS in the largest Canadian PD registry, C-OPN to population demographics can help determine whether there is the expected uptake of DBS in various groups.
Method: The retrospective study investigated PD patients who received DBS enrolled in C-OPN, which include 8 major research centers in Canada. Gender and self-reported ethnicity were analyzed, along with age, marital status, primary language spoken, region of residence, and education level. The data were compared with a larger dataset obtained at the University of Alberta.
Results: Among the 45 PD patients received DBS in C-OPN, male to female ratio is 2.64 (73% M). Patients who received DBS surgery were European descent (92.1%), French Canadian (2.6%), Hispanic/Latino (2.6%) and Indigenous (2.6%). No Asian or African Canadian were treated in C-OPN. The gender and ethnicity of the C-OPN cohort underrepresent population demographics in Canada. In addition, 87% were married or common law, 82.6% live in the urban area. English is the 1st language in 87.2% of people. Education level is not related to decision to DBS. The trends are congruent to the DBS cohort at the University of Alberta.
Conclusion: This study demonstrated the gender and ethnicity disparities when providing DBS for PD in the largest PD registry across Canada, raised awareness of necessity for improvement in providing quality care. In the future, we will use a mixed methods to identify the barriers and biases and to provide culturally sensitive education to improve access to necessary care with equality.
To cite this abstract in AMA style:
I. Ojo, S. Poonja, J. Miyasaki, A. Shetty, T. Sankar, F. Ba. Ethnic and Gender Disparities in Access to Deep Brain Stimulation for Parkinson’s Disease Among Participants in C-OPN [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/ethnic-and-gender-disparities-in-access-to-deep-brain-stimulation-for-parkinsons-disease-among-participants-in-c-opn/. Accessed September 7, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/ethnic-and-gender-disparities-in-access-to-deep-brain-stimulation-for-parkinsons-disease-among-participants-in-c-opn/