Drug prescribing patterns in Parkinson's disease: a pharmacoepidemiological survey in a cohort of ambulatory patients.
OBJECTIVE
Drug treatment of idiopathic Parkinson's disease (IPD) is a difficult task, and comorbidity and comedication add to its complexity. Since in IPD there is little information about drug use, this study investigated drug prescribing and indications in IPD patients.


METHODS
From June 1997 to April 1998, a cross-sectional survey of IPD outpatients was performed and demographic and clinical data and information about drug treatments was collected and analysed.


RESULTS
In the 130 IPD patients included in the study, anti-Parkinson drug (APD) prescriptions increased with disease duration and severity. Levodopa was most frequently used, followed by dopamine agonists and anticholinergic agents. Levodopa with other APDs was given to older patients with later IPD onset. Prescriptions of drugs for other indications (non-APDs) were given to 80.8% of the patients and their number increased with patient age. Non-APD prescriptions concerned mainly the circulatory system, mental disorders, the musculoskeletal system and the digestive system. Prescriptions for indications corresponding to secondary symptoms that often complicate IPD increased with patient age and also with IPD duration.


CONCLUSIONS
In IPD patients, disease duration and severity and patient age seem to be major determinants of drug use. Indications for drug prescription suggest that main comorbidity includes neuropsychiatric, circulatory, musculoskeletal and digestive disorders. Analysis of prescribing patterns in IPD can provide a readily accessible indirect indicator of patient health status for both health services and epidemiologic research purposes.
Leoni
Olivia
O
Center for Research in Clinical and Applied Pharmacology, Laboratory of Pharmacology, University of Insubria and University of Pavia, Varese, Italy.
Martignoni
Emilia
E
Cosentino
Marco
M
Michielotto
Donatella
D
Calandrella
Daniela
D
Zangaglia
Roberta
R
Riboldazzi
Giulio
G
Oria
Cristina
C
Lecchini
Sergio
S
Nappi
Giuseppe
G
Frigo
Gianmario
G
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003625:Data Collection; D015259:Dopamine Agents / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology; D017891:Pharmacoepidemiology / Q000379:methods / Q000706:statistics & numerical data*
D000978:Antiparkinson Agents; D018680:Cholinergic Antagonists; D015259:Dopamine Agents; D007980:Levodopa