OBJECTIVES: Essential tremor (ET) is a progressive, neurological disease characterized by tremor, most often of the hands or arms and impacts negatively on quality of life. The aims of this study were to assess patient characteristics and comorbidities.

METHODS: This retrospective cohort study was conducted using an administrative claims database from a large US healthcare payer. We identified patients with ET (ICD-10-CM: G250) during the study period (1/1/2017 – 12/31/2019). The earliest claim date with evidence of ET was identified as index date. Qualified patients were ≥22 years of age and had at least 6 months of enrollment before index date and 12 months of enrollment after index date. Patient demographics and comorbid conditions were assessed using all data within 6 months prior to and including the index date. Treatments were examined using all data within 12 months after the index date.

RESULTS: A total of 5,286 patients met eligibility criteria. Mean[SD] age was 70.8[11.8] years, 49.1% were female, 17.1% had commercial insurance, 82.9% had Medicare Advantage, 26.0% did not receive any ET-related pharmacotherapy or refractory surgery (untreated), 71.3% received some pharmacotherapy (pharmacotherapy), and only 2.7% had refractory surgery (surgery) during the 12-month follow-up period. Patients with refractory surgery were younger (untreated 72.0[11.3], pharmacotherapy 70.5[11.9], surgery 67.2[12.3], p<0.0001), more female (untreated 45.6%, pharmacotherapy 49.7%, surgery 69.7%, p<0.0001), and had smaller overall comorbidity burden (Age-adjusted Charlson Comorbidity Index; untreated 4.3[2.6], pharmacotherapy 4.4[2.8], surgery 3.7[2.3], p=0.0161). Five most common comorbidities were hyperlipidemia (65.5%), hypertension (63.2%), nonspecific gastritis/dyspepsia (29.6%), diabetes (22.9), ischemic heart disease (18.9%). Many patients had multiple comorbidities (overall 5.4[3.3], untreated 4.8[3.1], pharmacotherapy 5.5[3.2], surgery 5.5[3.3], p<0.0001).

CONCLUSIONS: Patient characteristics and comorbidities differed among ET patients with different treatments. Multiple comorbidities are highly prevalent among patients with ET and should be considered in the context of clinical decision making to optimize ET management.