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Black Americans newly diagnosed with Parkinson's disease are a quarter as likely as whites to walk out of their first office visit with a prescription for anti-PD treatment, according to a new study. Researchers identified new diagnoses of PD from Medicaid records in Pennsylvania between 1999 and 2003, excluding patients with possible secondary parkinsonism, as well as those who received anti-PD treatments in the prior 12 months. Of the 307 identified cases, 264 were white and 43 were black. Compared to historical averages for all PD patients, patients in this study were somewhat younger (mean age 55) and more likely to be female (61%), but there were no significant differences in these variables between blacks and whites. The initial visit was with a neurologist for 33% of blacks and 39% of whites (difference not significant); about 90% of both groups were eligible for Medicaid because of a disability; and blacks were more likely to receive care in an urban setting compared to whites (p<0.0001). Thirty-four percent of patients received a prescription for anti-PD medication or physical therapy at their first office visit, but the rates differed by race: 12% of blacks and 38% of whites received prescriptions. The odds ratio for receiving a prescription was 0.24 (95% confidence interval 0.09-0.64) for blacks. The two groups had about equal rates of six-month follow-up appointments. The authors point out that the sample was relatively young, poor, and disabled, and that "multiple comorbid conditions that require treatment may discourage clinicians from adding therapies with potential cross- interactions," potentially affecting the generalizability of the results to the larger population. "Our data cannot explain whether differences in treatment were due to differences in provider recommendations or differences in patient acceptance of treatment," the authors note. "Understanding the underlying causal mechanisms of these racial disparities such as patient and physician preferences, patient-physician communication, and confounding socioeconomic differences is important to develop interventions to reduce inequities in care and improve health for all patients with PD." Treatment disparities in Parkinson's disease N Dahodwala, M Xie, E Noll, A Siderowf, DS Mandell Ann Neurol 2009;66:142-145 ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn