Abstract
Background: During the past decade, there has been increasing awareness of the side effects of dopamine agonists (DAs), including impulse control disorders. We hypothesized that there may be a shift toward more conservative use of DAs. Objective: To explore the change in prescribing practices for dopaminergic medications in Parkinson's disease between 2010 and 2017. Methods: Data were collected from the Parkinson's Foundation Quality Improvement Initiative registry. Baseline characteristics were compared between the 2010 and 2017 cohorts using chi-squared tests for discrete and t tests for continuous variables. Logistic regressions were conducted for each class of medications to assess the effect of time points (2010 vs. 2017) and prespecified covariates on the probability of prescribing. Results: A total of 2,717 participants from 2010 and 2,900 participants from 2017 were included in the analysis. Mean (standard deviation) age was 67.4 (10) and 68.7 (9.3) for the 2010 and 2017 cohorts, respectively (P < 0.0001). After controlling for baseline characteristics, DA use was unchanged (P = 0.1172). The odds of using monoamine oxidase B inhibitors was 52% higher in 2017 than in 2010 (P < 0.0001), 38% lower for catechol-O-methyltransferase inhibitors (P < 0.0001), 25% lower for amantadine (P < 0.0001), and 31% lower for anticholinergics (P = 0.0153). There was no difference in the utilization of levodopa in the 2 cohorts (86.1% vs. 86.2%; P = 0.5783). Conclusions: Despite increasing awareness of impulse control disorders, there has been no reduction in the use of DAs during the past decade. Overall, there is less utilization of adjunctive classes of drugs except for an increase in the use of monoamine oxidase B inhibitors.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 687-692 |
| Number of pages | 6 |
| Journal | Movement Disorders Clinical Practice |
| Volume | 6 |
| Issue number | 8 |
| DOIs | |
| State | Published - Nov 1 2019 |
Funding
The authors would like to acknowledge Miriam Rafferty, PT, DPT, PhD, for her assistance with designing the initial proposal. T.S. has served as a consultant and received consulting fees from Acadia, Abbvie, Allergan, Anavex, Avid, GE Medical, Eli Lilly and Company, Harbor, Ibsen, IMPAX, Lundbeck, Merz, Inc., the National Parkinson Foundation, Navidea, Pfizer, TEVA Pharmaceuticals, Union Chimique Belge (UCB) Pharma, Voyager, US World Meds, and the Michael J. Fox Foundation (MJFF) for Parkinson's Research. T.S. has served as a speaker and received honoraria from Acadia, IMPAX, Lundbeck, TEVA Pharmaceuticals, and UCB Pharma and is on the scientific advisory boards for Anavex, Sanofi, and MJFF. T.S. sits on the advisory board for IMPAX and has received research funding from the National Institute of Neurological Disorders and Stroke (NINDS), MJFF, NPF, TEVA Pharmaceuticals, Auspex, Biotie, Civitas, Acorda, Lundbeck, Neuroderm, NINDS, National Institutes of Health, Northwestern Foundation, and the MJFF for Parkinson's Research. T.S. received funding support for educational programs from GE Medical, TEVA Pharmaceuticals, and Lundbeck. OD has served as a consultant and received consulting fees from Lundbeck.
Keywords
- Parkinson's disease
- dopaminergic agonists
- prescribing practices
ASJC Scopus subject areas
- Clinical Neurology
- Neurology