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- Title
Prevalence and Correlates of Anti-Parkinson Drug Use in a Nationally Representative Sample.
- Authors
Dahodwala, Nabila; Willis, Allison W.; Li, Pengxiang; Doshi, Jalpa A.
- Abstract
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.
- Subjects
DISEASE prevalence; PARKINSON'S disease treatment; DRUG utilization; MEDICARE; METHYLTRANSFERASES
- Publication
Movement Disorders Clinical Practice, 2017, Vol 4, Issue 3, p335
- ISSN
2330-1619
- Publication type
Article
- DOI
10.1002/mdc3.12422