Objective: To assess Asian American (AA), Native Hawaiians and Pacific Islanders (NHPI), and White Parkinson’s disease (PD) patients’ access to PD care among the first pilot PD cohort in Hawaii.

Background: AA and NHPI communities are markedly underrepresented in clinical trials. The prevalence of PD in hospitalized patients in Hawaii was significantly higher in the AA and White populations when compared to the NHPI population, with NHPI in Hawaii self-reporting significantly longer gaps between PD symptom onset and diagnosis. This may indicate differences in access to PD care between AA, NHPI, and Whites in Hawaii.

Method: This study recruited 78 PD patients (AA=27, NHPI=26, White=25) and analyzed their responses to a 29-item questionnaire assessing their access and barriers with their PD care at a baseline and 6-month follow-up visit. Statistical analyses were conducted using Fisher Exact and Chi-Squared tests for categorical data using R 4.4.3.

Results: Participants’ self-reported satisfaction of PD care, ability to afford PD medications, overall quality of their support systems, rates of seeking information on PD, and rates of preferring in-person over telehealth visits was similar between all three racial groups. Only 11% of AA participants reported barriers to PD care in the previous year compared 38% of NHPI and 28% of White participants. However, this difference was not statistically significant with our current sample size (p=0.065). Of the 20 participants reporting barriers to care, the most common barriers reported was services being unavailable in their local communities (N=14) and lack of transportation (N=6). The NHPI participants had a higher rate of internet-related challenges with telehealth (27%) and reported lower comfort with various technologies.

Conclusion: Based on our pilot findings, NHPI, AA, and White PD patients in Hawaii reported similar access to and satisfaction with PD care. Areas of improvement to provide equitable access to PD care include improving distribution of medical services to more local communities and improving participants’ comfort with technology.

References: Bruno, Michiko Kimura, et al. “The Prevalence of Hospitalized Parkinson’s Disease Patients in All Case Hospitalization among Different Race/Ethnic Subgroups in Hawaii.” Journal of Parkinson’s Disease, vol. 14, no. 4, 2024, pp. 725–35. PubMed, https://doi.org/10.3233/JPD-230341.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/disparities-in-parkinsons-disease-care-access-in-hawaii/