Drug therapies for Parkinson's disease: A database analysis of patient compliance and persistence

Tarrants, M.; Denarie, Michel; Castelli-Haley, Jane; Millard, Jennifer; Zhang, Dongmu

doi:10.1016/j.amjopharm.2010.08.001

Cited by 54 publications

(33 citation statements)

References 22 publications

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“…However, the determinants of medication compliance were similar between Western PD patients and subjects in Taiwan [26], [28]–[30]. In the related literature, the medication possession ratio in newly treated PD patients was around 50–75% during the first year [26], [28].…”

Section: Discussionmentioning

confidence: 84%

“…In the related literature, the medication possession ratio in newly treated PD patients was around 50–75% during the first year [26], [28]. In the present study, only 32.5% of patients could maintain medication uninterrupted during their first year [26]. Subjects with older ages, initial prescribing year between 2006 and 2010, receiving their first drugs from non-neurologists, receiving drugs from institutions other than medical centers, polypharmacy, higher one-year daily LDED and neuropsychiatric comorbidities such as stroke, dementia and psychiatric disorders had suboptimal medical persistence.…”

Section: Discussionmentioning

confidence: 99%

“…the follow-up period in this study). Having an MPR of more than 80% was classified as good compliance [26].…”

Section: Methodsmentioning

confidence: 99%

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Initial Medication in Patients of Newly Diagnosed Parkinson’s Disease in Taiwan

et al. 2014

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IntroductionSeveral treatment guidelines for Parkinson’s disease (PD) had been proposed in recent decades. The aim of current study was to investigate the initial medication utilized in newly diagnosed PD subjects in Taiwan during an eleven-year period.MethodsA total of 7,550 patients with newly diagnosed Parkinsonism were retrospectively enrolled from the National Health Insurance Research Database of Taiwan from 2000 to 2010. After excluding patients at risk of secondary or atypical Parkinsonism, those never receiving medication or having incomplete data, 1,645 subjects were included. The participants were then divided into four treating regimen groups, namely levodopa (LD) only group, dopamine agonist (DA) only group, LD+DA group, and No-LD, No-DA group. The demographic data and medication retention rate were compared across the four treatment groups.ResultsLD only and No-LD, No-DA regimens were the main initial choice of PD treatment in Taiwan. LD containing drugs were more often prescribed to the elderly population than the other two treatment regimens, while No-LD, No-DA medication was the major initial choice for younger patients. DA only regimen occupied only 3–4% of the initial PD prescriptions and was given predominantly by neurologists. Over the eleven-year period, there is a trend for the middle-aged population to receive medication containing LD as initial treatment. The one year retention rate of anti-Parkinsonism medication was around 30–50% in our population. Age, polypharmacy, change of one-year daily levodopa equivalent dosage and newly onset of dementia, stroke and psychiatric diseases all affect drug compliance in PD patients.ConclusionsThis is the first long-term study to explore initial pharmacotherapies in an Asian PD population. We hope to provide evidence for adjusting government policies and public education of physicians and PD patients in the future.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Initial Medication in Patients of Newly Diagnosed Parkinson’s Disease in Taiwan

et al. 2014

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“…Suboptimal adherence to medication is a frequent phenomenon in PD, resulting in symptom worsening and increased health care costs [9][10][11]. Several methods have been used to assess the degree of adherence to treatment, including self-report measures, direct pill counts, electronic monitoring of pill counts (bottle opening electronic recordings) and biological methods [12].…”

Section: Discussionmentioning

confidence: 99%

Levodopa dosage determines adherence to long-acting dopamine agonists in Parkinson's disease

Santos‐García¹,

Prieto-Formoso²,

Fuente‐Fernández³

2012

Journal of the Neurological Sciences

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“…These agents generally have different administration/dosing schedules, with the resulting regimen complexity making it difficult for patients to remain compliant to treatment. Indeed, initial reports have indicated that there may be widespread irregularity between patients in their compliance with PD treatment [14, 15], with one study estimating that 46 % of patients taking orally delivered medications are non-compliant [16]. Compliance can be defined as the extent to which a patient’s actual drug timing, administration, and dose corresponds to that which is prescribed for them; in clinical trials, compliance is usually measured by a tablet count [17].…”

Section: Introductionmentioning

confidence: 99%

Compliance with Pharmacotherapy and Direct Healthcare Costs in Patients with Parkinson’s Disease: A Retrospective Claims Database Analysis

Richy

Pietri²,

Moran

et al. 2013

Appl Health Econ Health Policy

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BackgroundParkinson’s disease (PD) is a progressive neurological disorder for which, at present, there is no cure. Current therapy is largely based on the use of dopamine agonists and dopamine replacement therapy, designed to control the signs and symptoms of the disease. The majority of current treatments are administered in tablet form and can involve multiple daily doses, which may contribute to sub-optimal compliance. Previous studies with small groups of patients suggest that non-compliance with treatment can result in poor response to therapy and may ultimately increase direct and indirect healthcare costs.ObjectiveTo determine the extent of non-compliance within the general PD population in the USA as well as the patient characteristics and healthcare costs associated with compliance and non-compliance.MethodsA retrospective analysis from a managed care perspective was conducted using data from the USA PharMetrics patient-centric claims database. PharMetrics claims data were complete from 31 December 2005 to 31 December 2009. Patients were included if they had at least two diagnoses for PD between 31 December 2005 and 31 December 2008, were older than 18 years of age, were continuously enrolled for at least 12 months after the date of the most recent PD diagnosis, and had no missing or invalid data. The follow-up period was the most recent 12-month block of continuous enrollment that occurred between 2006 and 2009. Patients were required to have at least one PD-related prescription within the follow-up period. The medication possession ratio (MPR) was used to categorise patients as compliant or non-compliant. Direct all-cause annual healthcare costs for patients with PD were estimated for each patient, and regression analyses were conducted to determine predictors for non-compliance.ResultsA total of 15,846 patients were included, of whom 46 % were considered to be non-compliant with their prescribed medication (MPR <0.8). Predictors of non-compliance included prescription of a medication administered in multiple daily doses (p < 0.0001), a period of <2 years since the initial PD diagnosis (p = 0.0002), a diagnosis of gastrointestinal disorder (p < 0.0001), and a diagnosis of depression (p < 0.0001). Non-compliance was also found to be related to age, with a lower odds of non-compliance in patients aged 41–80 years than in patients aged ≥81 years (p < 0.05). Although total drug mean costs were higher for compliant patients than non-compliant patients (driven mainly by the cost of PD-related medications), the mean costs associated with emergency room and inpatient visits were higher for patients non-compliant with their prescribed medication. Overall, the total all-cause annual healthcare mean cost was lower for compliant ($77,499) than for non-compliant patients ($84,949; p < 0.0001).ConclusionNon-compliance is prevalent within the general USA PD population and is associated with a recent PD diagnosis, certain comorbidities, and multiple daily treatment dosing. Non-compliance may increase the burden on the...

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Drug therapies for Parkinson's disease: A database analysis of patient compliance and persistence

Cited by 54 publications

References 22 publications

Initial Medication in Patients of Newly Diagnosed Parkinson’s Disease in Taiwan

Initial Medication in Patients of Newly Diagnosed Parkinson’s Disease in Taiwan

Levodopa dosage determines adherence to long-acting dopamine agonists in Parkinson's disease

Compliance with Pharmacotherapy and Direct Healthcare Costs in Patients with Parkinson’s Disease: A Retrospective Claims Database Analysis

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