Establishing a comprehensive questionnaire for detecting drug-induced extrapyramidal symptoms.
OBJECTIVE
Drug-induced extrapyramidal symptoms (DIEPS) often substantially compromise quality of life (QOL) of patients receiving drugs with central antidopaminergic activities. A lack of comprehensive screening method based upon patients' subjective symptoms for detecting DIEPS appears to have prevented pharmacists from delivering satisfactory pharmaceutical care for these patients. Thus, we have attempted to develop a comprehensive questionnaire for screening patients having higher risks of developing DIEPS.


METHODS
One hundred fourteen outpatients taking gastroprokinetic drugs (itopride, cisapride, trimebutine, domperidone and metoclopramide) at least 2 weeks participated in the study. One patient with familial Parkinson disease served as a positive reference. They undertook a questionnaire consisting of 9 comprehensive questions written in non-technical words that were aimed to detect typical symptoms of Parkinsonism including akathisia and dyskinesia. Each symptom was scored in a semiquantitative scale [i.e., from 1 (not at all) to 5 (very much)] by the patients.


RESULTS
Of the 108 subjects who successfully completed the questionnaires, 43 gave scores 2 or greater indicating the presence of DIEPS. However, no statistically significant correlations were observed between the scores of any possible pairs of the questionnaire items. Five subjects had a mean questionnaire score of equal to or greater than 1.6, and the patient with familiar Parkinsonism had the highest mean score of 1.9.


CONCLUSIONS
The questionnaire presented herein detected 4 patients with suspected DIEPS. Further studies should be warranted to assess whether it would be useful for pharmacists as a screening tool for DIEPS in patients having higher risks of DIEPS.
Department of Medication Use Analysis and Clinical Research, Meiji Pharmaceutical University, Japan.
Keiko
K
Ohno
Shinsuke
S
Miyazawa
Masayuki
M
Hashiguchi
Tamao
T
Unemoto
Atsuo
A
Itoh
Hirotoshi
H
Echizen
Tadaaki
T
Rikihisa
Hiroyasu
H
Ogata
Masahiro
M
Murata
D000368:Aged; D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D001549:Benzamides / Q000009:adverse effects*; D001593:Benzyl Compounds / Q000009:adverse effects*; D020117:Cisapride / Q000009:adverse effects*; D004294:Domperidone / Q000009:adverse effects*; D018492:Dopamine Antagonists / Q000009:adverse effects*; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014287:Trimebutine / Q000009:adverse effects*
D001549:Benzamides; D001593:Benzyl Compounds; D018492:Dopamine Antagonists; D005765:Gastrointestinal Agents; D004294:Domperidone; C102254:itopride; D008787:Metoclopramide; D014287:Trimebutine; D020117:Cisapride