Trends in inpatient antiparkinson drug use in the USA, 2001–2012

Crispo, James A.G.; Fortin, Yannick; Thibault, Dylan; Emons, Matthew F.; Bjerre, Lise M.; Kohen, Dafna; Pérez-Lloret, Santiago; Mattison, Donald R.; Willis, Allison W.; Krewski, Daniel

doi:10.1007/s00228-015-1881-4

Cited by 43 publications

(75 citation statements)

References 41 publications

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“…Additionally, our multiple case‐control study design resulted in our analyses being better powered to detect associations between nonergot DAs and more common outcomes, such as HF and ischemic stroke. While analyses of inpatients with PD may impose limitations to external validity, we have previously reported that inpatients with PD are hospitalized for reasons that are consistent with inpatient admissions among older adults in the United States . Lastly, the present analysis involved a large number of statistical tests based on four cardiovascular and two cerebrovascular outcomes, as well as different classes of nonergot DAs (pramipexole and ropinirole) and different referent groups (no use or LD monotherapy).…”

Section: Discussionsupporting

confidence: 93%

“…While analyses of inpatients with PD may impose limitations to external validity, we have previously reported that inpatients with PD are hospitalized for reasons that are consistent with inpatient admissions among older adults in the United States. 41 Lastly, the present analysis involved a large number of statistical tests based on four cardiovascular and two cerebrovascular outcomes, as well as different classes of nonergot DAs (pramipexole and ropinirole) and different referent groups (no use or LD monotherapy). A formal adjustment for multiple comparisons was not made, because our analyses are considered largely exploratory.…”

Section: Discussionmentioning

confidence: 99%

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Associations Between Cardiovascular Events and Nonergot Dopamine Agonists in Parkinson's Disease

Crispo

Willis

Thibault

et al. 2015

Movement Disord Clin Pract

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Background Knowledge of possible cardiovascular risks from Parkinson's disease (PD) medications is critical to informing safe and effective treatment decisions. The objective of our study was to determine whether PD patients treated with nonergot dopamine agonists (DAs) are at increased risk of adverse cardiovascular or cerebrovascular outcomes, relative to PD patients receiving other treatments. Methods Matched case‐control studies were conducted within a cohort of 14,122 inpatients receiving treatment for PD who were identified in the Cerner Health Facts database. Primary outcomes were associations between nonergot DA use and diagnosis of adverse cardiovascular events (acute myocardial infarction, heart failure [HF], hypotension, and valvulopathy). Secondary outcomes included associations between nonergot DA use and diagnosis of adverse cerebrovascular events (cerebrovascular accident and ischemic stroke) and odds of significant exposure‐outcome relationships by patient factors. Results HF was the only adverse event that demonstrated a significant association with nonergot DA use. Individuals treated with pramipexole were more likely to be diagnosed with HF, relative to no use (adjusted odds ratio [AOR]: 1.28; 95% confidence interval [CI]: 1.07–1.53). The association between pramipexole and HF was greater among individuals treated with pramipexole monotherapy (relative to levodopa monotherapy) (AOR, 1.50; 95% CI: 1.09–2.06). Compared to nonusers, men and older individuals treated with pramipexole were more likely to be diagnosed with HF. Conclusions Results from our study suggest an association between pramipexole use and HF. Findings warrant replication; however, individuals with PD and independent risk factors for, or a history of, HF may benefit from limited use of this drug.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Associations Between Cardiovascular Events and Nonergot Dopamine Agonists in Parkinson's Disease

Crispo

Willis

Thibault

et al. 2015

Movement Disord Clin Pract

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“…Among incident cases of PD in the United States, l ‐dopa is prescribed as initial therapy in greater than 70% of individuals . In population‐based studies in Italy and France, the results are similar; and, in a sample of hospitalized patients with PD, 85% are treated with l ‐dopa …”

Section: Discussionmentioning

confidence: 96%

Prevalence and Correlates of Anti‐Parkinson Drug Use in a Nationally Representative Sample

Dahodwala

Willis

et al. 2016

Movement Disord Clin Pract

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Background Although numerous prescription drugs are available to treat Parkinson's disease (PD), little is known about national use in clinical practice and which factors may influence variability in care. The objectives of this study were to describe the prevalence of anti‐Parkinson drug use among Medicare beneficiaries with PD and to identify demographic and clinical factors associated with drug use. Methods This retrospective study was based on a random sample of annual 5% Medicare Part A and B claims linked with Medicare Part D drug files from 2007 through 2010. The study sample included fee‐for‐service Medicare beneficiaries with continuous stand‐alone Part D enrollment who had been diagnosed with PD in the given year. First, any PD drug use and drug use by class (levodopa, dopamine agonist, anticholinerigc, monoamine oxidase B inhibitors, catechol‐O‐methyltransferase inhibitors, and amantadine) were described. Using generalized estimating equation regressions, patient and provider characteristics associated with anti‐Parkinson drug use and choice were examined. Results Over 81% of patients with PD were treated with anti‐Parkinson drugs, and this proportion was stable over the 4 years of the study. The majority were treated with levodopa (90%); followed by dopamine agonists (29–31%); then monoamine oxidase B inhibitors, anticholinergics, amantadine, and catechol‐O‐methyltransferase inhibitors (all between 5% and 11%). Holding all else equal, patients who were not seen by a neurologist (odds ratio, 0.41; 95% confidence interval, 0.38–0.44; P < 0.001) and African‐American patients (odds ratio, 0.80; 95% confidence interval, 0.69–0.93; P = 0.003) were significantly less likely to be treated. Conclusions Among a national sample of Medicare beneficiaries with PD, the majority received anti‐Parkinson drugs. However, there was relative under‐treatment of African‐Americans and patients who were not seen by a neurologist for care.

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“…had EDS. The ratio of DA utilization in our patients was higher than that reported in the United States (Crispo et al., 2015). More than 50% of the patients in our series received DAs, which may increase daytime sleepiness.…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbances in Taiwanese patients with Parkinson's disease

Lin

Chen

et al. 2017

Brain and Behavior

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IntroductionSleep disturbance is a common nonmotor symptom of Parkinson's disease (PD) and strongly affects patients’ quality of life. The relationship between excessive daytime sleepiness (EDS) and nighttime problems remains uncertain. Arguments persist regarding the risk factors for sleep disturbance among patients with PD. Furthermore, the prevalence of EDS appears to be lower in Asian countries. Herein, we conducted the study to describe the characteristics of sleep problems in a sample of Taiwanese PD patients and delineate the difference with reported sleep disturbances in Caucasian PD patients from the literature.MethodsPatients with PD were recruited from the outpatient clinic of a tertiary medical center and were evaluated using standardized assessment protocols, including the Parkinson's Disease Sleep Scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and 39‐Item Parkinson's Disease Questionnaire (PDQ‐39).ResultsA total of 225 patients with PD were recruited. The mean age of patients with PD was 65.7 years old and the mean disease duration was 8.18 years. Among the patients, 53.8% were defined as poor sleepers (PSQI > 5) and 26.3% had EDS. Seventy‐one percent of the poor sleepers used hypnotic medications. The poor sleepers were worse in the scores of Unified Parkinson's Disease Rating Scale (UPDRS), PDSS, and the PDQ‐39, and received higher levodopa daily dosage. A PDSS score of <126 indicate that a patient with PD was a poor sleeper. EDS was positively correlated with advanced Hoehn and Yahr stages and use of dopamine agonists but not with levodopa daily dosage and levodopa equivalent daily dosage.ConclusionsTaiwanese patients with PD had a lower prevalence of EDS compared with the literatures reported in Caucasian patients. We identify and suggest that PDSS total score, rather than subcategory items, should be used to predict poor sleep among patients with PD.

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Trends in inpatient antiparkinson drug use in the USA, 2001–2012

Cited by 43 publications

References 41 publications

Associations Between Cardiovascular Events and Nonergot Dopamine Agonists in Parkinson's Disease

Associations Between Cardiovascular Events and Nonergot Dopamine Agonists in Parkinson's Disease

Prevalence and Correlates of Anti‐Parkinson Drug Use in a Nationally Representative Sample

Sleep disturbances in Taiwanese patients with Parkinson's disease

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