title: Huntington's disease: current epidemiology and pharmacological management in UK primary care.
abstract: BACKGROUND
  Recent debate suggests Huntington's disease (HD) may be more prevalent than previously reported. In addition, relatively little is known about current disease management. This study aims to provide epidemiological data and describe the pharmacological management of HD in the United Kingdom.
  
  
  METHODS
  A primary care research database was accessed to identify incident and prevalent HD cases between January 1, 2004, and December 31, 2008. Patients with Read codes denoting a definite diagnosis or possible diagnosis, and undiagnosed patients with a positive family history were identified. A subset of patients with a definite diagnosis and prescribed medication indicating symptom onset was also identified. Epidemiological data were estimated. Pharmacological prescriptions to HD patients from 2004 to 2008 were identified, and prescription frequencies were grouped according to the British National Formulary categories.
  
  
  RESULTS
  HD incidence estimates ranged from 0.44 to 0.78 per 100,000 person-years, and HD prevalence ranged from 5.96 to 6.54 per 100,000 of the population. Forty-four percent of pharmacological prescriptions targeted the central nervous system. Nearly half of the HD patients were prescribed antidepressants, and over 40% were prescribed analgesics.
  
  
  CONCLUSIONS
  Although prevalence estimates fell short of figures suggested in recent debate, it is feasible that the true prevalence may be much higher than previously reported. Pharmacological management appears to rely heavily on central nervous system drugs and nutrition support. Many of these drugs are prescribed to HD patients for reasons other than the medication's primary use. Further work is required to evaluate the impact of alternative management strategies, such as therapist intervention, counselling, and organisation support, on the patients' quality of life.
authors: School of Health and Population Sciences, University of Birmingham, Birmingham, UK. c.m.sackley@bham.ac.uk
authors: Catherine
authors: C
authors: Sackley
authors: Thomas J
authors: TJ
authors: Hoppitt
authors: Melanie
authors: M
authors: Calvert
authors: Paramjit
authors: P
authors: Gill
authors: Benjamin
authors: B
authors: Eaton
authors: Guiqing
authors: G
authors: Yao
authors: Hardev
authors: H
authors: Pall
mesh_terms: D017668:Age of Onset; D000700:Analgesics / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D002491:Central Nervous System Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D018529:Nutritional Support / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000700:Analgesics; D000928:Antidepressive Agents; D002491:Central Nervous System Agents