Clinical and economic analysis of spa therapy in Parkinson's disease

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Abstract
The effectiveness of spa therapy in the management of patients with Parkinson's disease (PD) has never been evaluated. This is assessed in this pilot study. A prospective, randomized, cross‐over, controlled study was conducted in 31 PD patients who underwent a 20‐week spa period, including spa therapy for 3 weeks, and a 20‐week non‐spa period. Effectiveness was assessed using quality of life scales (PDQ‐39 and SF‐36), motor scale (UPDRS) and psychological questionnaire (GHQ‐28), at baseline and at 4 (T4) and at 20 weeks (T20). Direct medical costs (radiological and laboratory tests, physician fees, drug therapy, and ancillary care) were recorded over each 20‐week period. At T4, spa therapy improved significantly several dimensions of PDQ‐39 and SF‐36, part IV of the UPDRS, and GHQ‐28. At T20, no difference in any parameter was found. The mean direct medical cost over 20 weeks (€1,328 ± 167; £776 ± 97 per patient) in the spa period was slightly but significantly reduced in comparison with that of the non‐spa period (€1380 ± 523; £807 ± 306 per patient). This cost‐effectiveness analysis suggests that spa therapy is more effective and less expensive than conventional treatment alone and could be beneficial in the management of PD.