Prescribing Pattern for Parkinson’s Disease in Indian Community before Referral to Tertiary Center

Surathi, Pratibha; Kamble, Nitish; Bhalsing, Ketaki Swapnil; Yadav, Ravi; Pal, Pramod Kumar

doi:10.1017/cjn.2017.208

Cited by 10 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 44 studies, 35 were designed to examine the prescribing pattern of PD medications with or without measuring prescribing determinants (Table 1) [41–48, 50, 51, 53–75, 83, 84] and 9 studies measured the prescribing determinants and utilisation factors without measuring prescription rates of PD medications (Table 2) [49, 52, 76–82]. The sources of data varied according to each study design; insurance-claims, prescription registries, or drug sales databases in 16 studies [45–47, 53, 54, 56–58, 61, 62, 64, 65, 72, 75, 81, 83]; medical charts and administrative databases in 13 studies [41–43, 48, 50, 51, 66–70, 79, 82]; patients' interviews, questionnaires, or surveys in 12 studies [44, 55, 59, 60, 63, 71, 73, 74, 76–78, 84]; and finally, 3 studies were designed as post hoc studies that used previously conducted clinical trials to find the prescribing patterns and determinates of PD medications (see Tables 1 and 2) [49, 52, 80]. The timeframe of the studies that were reviewed was from 1986 to 2017.…”

Section: Resultsmentioning

confidence: 99%

“…In the prescribing pattern studies, number of patients treated per 100,000 inhabitants, number of prescriptions, number of patients prescribed a particular medication, defined daily doses (DDD) per 1000 inhabitants per day (DID), and number of person-years were used as units of analysis in all studies except one study conducted in England that used drug sales as a unit of analysis [58]. In the studies that used the number of patients prescribed a particular medication [41–43, 45, 47, 48, 51, 54, 55, 59–61, 66, 68–71, 73–75, 83, 84] or the number of person-years [64] as units of analysis, the total prescription rates of all PD medications may not add up to 100% due to the possibility that the patients were prescribed combination therapy. On the contrary, the studies that used the number of prescriptions or DID as units of analysis [53, 57, 62, 65, 67, 72], the total prescription rates of all PD medications may not add up to 100% due to rounding off to the nearest percent or due to the inability to calculate some categories of PD medication prescription rates.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Patterns and Determinants of Prescribing for Parkinson’s Disease: A Systematic Literature Review

Orayj

Lane

2019

Parkinson's Disease

View full text Add to dashboard Cite

Since the discovery of levodopa (L-dopa) in 1967, the range of medications available to treat Parkinson's disease has increased significantly and guidance on the use, efficacy, and safety of these medications has evolved. To assess levels of adherence to national prescribing guidelines and awareness of changes in the efficacy and safety data published in the profiles of medications for the treatment of PD, we have reviewed studies on patterns and determinants of prescribing PD medications conducted in the last 50 years (since the discovery of L-dopa). A systematic literature review was conducted using EMBASE (1967 to March, 2018), Ovid MEDLINE(R) ALL (1967 to March 16, 2018), PsycINFO (1967 to the 2nd week of March, 2018), and PubMed to identify all studies measuring prescribing patterns of PD medication between 1967 and 2017. Study design, source of data, country, year of study, number of patients and/or prescriptions, unit of analysis, prescribing determinants, and percentage utilisation of PD medications were extracted where possible. 44 studies examining prescribing patterns and/or prescribing determinants across 17 countries were identified. Unsurprisingly, L-dopa was the most commonly prescribed medication in all studies, accounting for 46.50% to 100% of all prescriptions for PD. In several studies, the prescribing rate of ergot-derived dopamine agonists (DAs) decreased over time in concordance with guidance. In contrast, the prescribing rates of non-ergot DAs increased over the last ten years in most of the included studies. In examining prescribing factors, two major categories were exemplified, patients' factors and prescribers' factors, with patients' age being the most common factor that affected the prescription in most studies. In conclusion, L-dopa is now the most commonly prescribed medication for cases of PD but there is large variation in the prescribing rates of catechol-O-methyltransferase (COMT) inhibitors, monoamine oxidase B (MAO-B) inhibitors, amantadine, and anticholinergics between countries. New studies examining the effects of recent clinical trials and measuring the prescribing rates of newly approved medications are warranted.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Patterns and Determinants of Prescribing for Parkinson’s Disease: A Systematic Literature Review

Orayj

Lane

2019

Parkinson's Disease

View full text Add to dashboard Cite

show abstract

“…Few data on temporal trends in Parkinson drugprescribing patterns in drug-naïve PD patients exist. Most available studies on drug-prescribing patterns in PD have been cross-sectional analyses or use the drug tracer methodology, making it difficult to identify changing patterns in PD drug utilization or patient factors that influence the choice of drug [4][5][6]. In studies with longitudinal data, analyses were on patients with a varied duration of illness; thus, were not designed to answer which dopaminergic replacement strategy was preferred by physicians as initial therapy [7,8].…”

Section: Introductionmentioning

confidence: 99%

Evolution of Initial Pharmacologic Treatment of Newly Diagnosed Parkinson’s Disease Patients over a Decade in Singapore

Neo

Wong

et al. 2020

Parkinson's Disease

View full text Add to dashboard Cite

Objective. The aim of this study is to compare Parkinson’s disease (PD) treatment practices by movement disorder (MD) specialists across a decade, and to determine the factors that influence drug choice for the motor symptoms of PD in newly diagnosed drug-naïve patients. Methods. This prospective temporal analysis included patients seen at the National Neuroscience Institute in Singapore and diagnosed with PD by MD specialists in the years 2007 and 2017. Primary outcomes were use of specific PD drugs and changes in drug-prescribing patterns. Descriptive analyses and multivariable logistic regression models determined the extent to which patient characteristics were associated with type of PD treatment. Results. Of 230 patients with PD (mean (SD) age, 66.7 (10.3) years), 131 (57.0%) were male. From 2007 to 2017, the use of ergot dopamine agonists and anticholinergics decreased from 19.3% to 2.0% (P<0.001) and from 12.0% to 2.7% (P=0.004), respectively. The use of monoamine oxidase B inhibitors (MAOBI) increased from 13.3% to 25.2% (P=0.033). The use of levodopa (LD)-sparing strategies decreased nonsignificantly from 33.7% to 24.5% (P=0.133). Overall, 196 (85.2%) patients were initiated on symptomatic monotherapy, with LD being the most commonly prescribed. MAOBI was the most common drug used in combination therapy. Age ≤70 (adjusted OR, 11.9; 95% CI, 4.5–31.5) and Hoehn and Yahr (HY) stage <2 (adjusted OR, 3.4; 95% CI, 1.5–7.7) were independent factors for LD-sparing strategies. Non-LD prescriptions (13 of 92; 14.1%) were more likely to be discontinued compared to LD ones (6 of 149; 4.0%) (P=0.005). Conclusions. Drug-prescribing patterns in PD have changed significantly through the last decade, influenced by emerging evidence and reports of adverse drug effects. Choosing drugs based on the patient’s age and disease severity remain sound guiding principles across the years. It is important that international and national guidelines for pharmacotherapy in PD be updated consistently throughout different socioeconomic settings to optimize care.

show abstract

“…12 Results observed in a study carried out in Karnataka, show that Levodopa was prescribed in 94.8%, Trihexyphenidyl in 40.4%, dopamine agonists in 23.2%, and Amantadine in 17.2% either as monotherapy or in combination. 13 In our study, out of 106 anti-Parkinson drugs prescribed, 45% were Levodopa and Carbidopa combinations, followed by dopamine agonists (18%), anticholinergic drugs (15%), amantadine (12%), MAO inhibitors (5%) and COMT inhibitors (5%).…”

Section: Drug Utilization Patternmentioning

confidence: 56%

Drug utilization pattern and analysis of quality of life in Indian patients of Parkinson’s disease

Shah¹,

Joshi²,

Sood³

et al. 2019

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Background: Parkinson's disease (PD) is a highly debilitating disease characterized by tremors, bradykinesia and rigidity. It leads to lowered self-esteem and psychological consequences which affect quality of life. The aim of this study is to study the drug utilization pattern and assess the quality of life in patients of Parkinson’s Disease.Methods: 40 patients of PD at least 1 month duration and 20 age-based controls were analyzed for quality of life using Parkinson’s Disease Questionnaire-39 (PDQ-39). Drug prescriptions were analyzed.Results: Mean number of anti-Parkinson drugs prescribed is 2.65±1.21. Of 106 anti-Parkinson drugs prescribed, 45% were levodopa and carbidopa combinations, followed by dopamine agonists (18%), anticholinergic drugs (15%), amantadine (12%), MAO inhibitors (5%) and COMT inhibitors (5%). There were significant problems in speech, performance of daily chores and daytime somnolence (p<0.0001). Depression, isolation, cognitive decline and memory loss were noteworthy in the patients as compared to controls (p<0.05). 25% patients felt embarrassed due to their disease; 59% felt affected by others’ opinion, 60% felt difficulty in communicating with others (p<0.05). Almost 2/3rd patients needed help in personal care as compared to the control group (p<0.0001).Conclusions: Quality of life of parkinsonian patients is severely affected in spite of them receiving a large number of drugs. This may be both due to disease progression as well as medication. Levodopa-carbidopa combination is the most prescribed medication. Use of levodopa and carbidopa combination must be evaluated properly. Newer guidelines and interventions are the need of the hour which may provide a better outcome on the quality of life of parkinsonian patients.

show abstract

Prescribing Pattern for Parkinson’s Disease in Indian Community before Referral to Tertiary Center

Cited by 10 publications

References 26 publications

Patterns and Determinants of Prescribing for Parkinson’s Disease: A Systematic Literature Review

Patterns and Determinants of Prescribing for Parkinson’s Disease: A Systematic Literature Review

Evolution of Initial Pharmacologic Treatment of Newly Diagnosed Parkinson’s Disease Patients over a Decade in Singapore

Drug utilization pattern and analysis of quality of life in Indian patients of Parkinson’s disease

Contact Info

Product

Resources

About