scholarly journals Evolution of Initial Pharmacologic Treatment of Newly Diagnosed Parkinson’s Disease Patients over a Decade in Singapore

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Shermyn Neo ◽  
Sheng Yong Aidan Wong ◽  
Hwee Lan Ng ◽  
Wei Li ◽  
Kay Yaw Tay ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Effects ◽  
Patient Characteristics ◽  
Temporal Analysis ◽  
Prescribing Patterns ◽  
Newly Diagnosed ◽  
Drug Prescribing ◽  
National Guidelines ◽  
Logistic Regression Models

Objective. The aim of this study is to compare Parkinson’s disease (PD) treatment practices by movement disorder (MD) specialists across a decade, and to determine the factors that influence drug choice for the motor symptoms of PD in newly diagnosed drug-naïve patients. Methods. This prospective temporal analysis included patients seen at the National Neuroscience Institute in Singapore and diagnosed with PD by MD specialists in the years 2007 and 2017. Primary outcomes were use of specific PD drugs and changes in drug-prescribing patterns. Descriptive analyses and multivariable logistic regression models determined the extent to which patient characteristics were associated with type of PD treatment. Results. Of 230 patients with PD (mean (SD) age, 66.7 (10.3) years), 131 (57.0%) were male. From 2007 to 2017, the use of ergot dopamine agonists and anticholinergics decreased from 19.3% to 2.0% (P<0.001) and from 12.0% to 2.7% (P=0.004), respectively. The use of monoamine oxidase B inhibitors (MAOBI) increased from 13.3% to 25.2% (P=0.033). The use of levodopa (LD)-sparing strategies decreased nonsignificantly from 33.7% to 24.5% (P=0.133). Overall, 196 (85.2%) patients were initiated on symptomatic monotherapy, with LD being the most commonly prescribed. MAOBI was the most common drug used in combination therapy. Age ≤70 (adjusted OR, 11.9; 95% CI, 4.5–31.5) and Hoehn and Yahr (HY) stage <2 (adjusted OR, 3.4; 95% CI, 1.5–7.7) were independent factors for LD-sparing strategies. Non-LD prescriptions (13 of 92; 14.1%) were more likely to be discontinued compared to LD ones (6 of 149; 4.0%) (P=0.005). Conclusions. Drug-prescribing patterns in PD have changed significantly through the last decade, influenced by emerging evidence and reports of adverse drug effects. Choosing drugs based on the patient’s age and disease severity remain sound guiding principles across the years. It is important that international and national guidelines for pharmacotherapy in PD be updated consistently throughout different socioeconomic settings to optimize care.

scholarly journals Characteristics of Parkinson’s Disease in Patients with and without Cognitive Impairment

2021 ◽  
pp. 1-12
Author(s):  
Julie Chandler ◽  
Radhika Nair ◽  
Kevin Biglan ◽  
Erin A. Ferries ◽  
Leanne Munsie ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Emergency Department ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Memory Loss ◽  
Patient Characteristics ◽  
Emergency Department Visits ◽  
Administrative Claims ◽  
Newly Diagnosed ◽  
Comorbidity Burden

Background: Characterizing patients with Parkinson’s disease (PD) and cognitive impairment is important toward understanding their natural history. Objective: Understand clinical, treatment, and cost characteristics of patients with PD pre- and post-cognitive impairment (memory loss/mild cognitive impairment/dementia or dementia treatment) recognition. Methods: 2,711 patients with PD newly diagnosed with cognitive impairment (index) were identified using administrative claims data. They were matched (1:1) on age and gender to patients with PD and no cognitive impairment (controls). These two cohorts were compared on patient characteristics, healthcare resource utilization, and total median costs for 3 years pre- and post-index using Chi-square tests, t-tests, and Wilcoxon rank-sum tests. Logistic regression was used to identify factors predicting cognitive impairment. Results: Comorbidity indices for patients with cognitive impairment increased during the 6-year study period, especially after the index. Enrollment in Medicare Advantage Prescription Drug plans vs. commercial (OR = 1.60), dual Medicare/Medicaid eligibility (OR = 1.36), cerebrovascular disease (OR = 1.24), and PD medication use (OR = 1.46) were associated with a new cognitive impairment diagnosis (all p <  0.05). A greater proportion of patients with cognitive impairment had hospitalizations and emergency department visits and higher median total healthcare costs than controls for each year pre- and post-index. Conclusion: In patients with PD newly diagnosed with cognitive impairment, comorbidity burden, hospitalizations, emergency department visits, and total costs peaked 1-year pre- and post-identification. These data coupled with recommendations for annual screening for cognitive impairment in PD support the early diagnosis and management of cognitive impairment in order to optimize care for patients and their caregivers.

Drug prescribing patterns in Parkinson's disease: a pharmacoepidemiological survey in a cohort of ambulatory patients

2002 ◽  
Vol 11 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Olivia Leoni ◽  
Emilia Martignoni ◽  
Marco Cosentino ◽  
Donatella Michielotto ◽  
Daniela Calandrella ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Prescribing Patterns ◽  
Drug Prescribing ◽  
Ambulatory Patients

scholarly journals The Profile of People with Parkinson’s Disease Included in Community Boxing Exercise Programs

2021 ◽  
Vol 5 (1) ◽  
pp. 5
Author(s):  
Josefa Domingos ◽  
Tamine Capato ◽  
Catarina Godinho
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Negative Impact ◽  
Patient Characteristics ◽  
Inclusion Criteria ◽  
Exercise Programs

Exercise is widely recommended for people with Parkinson (PD). Boxing is a popular mode of training. However, including individuals with less favorable profiles may have a negative impact on participation. We performed a systematic review to study the patient characteristics that were included in boxing exercise programs research and reflect on the possible inclusion criteria that professionals can use for boxing exercise programs. Indications for the best profiles were limited due to the small number of studies. Boxing programs should include people with the diagnosis of PD in earlier stages, independently ambulatory, and without current severe musculoskeletal or cardiovascular conditions.

scholarly journals Rehabilitation Therapy Utilization in Patients with Parkinson’s Disease in Korea

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Han Gil Seo ◽  
Sang Jun Park ◽  
Jiah Seo ◽  
Seong Jun Byun ◽  
Byung-Mo Oh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Health Insurance ◽  
Clinical Practice ◽  
Patient Characteristics ◽  
National Sample ◽  
Present Evidence ◽  
Rehabilitation Therapy ◽  
Swallowing Therapy ◽  
Over Time

Objective. Although evidence and guidelines recommend appropriate rehabilitation from the beginning of diagnosis in patients with Parkinson’s disease (PD), there is a lack of data addressing the utilization of rehabilitation therapies for these patients in practice. The aim of this study is to investigate the rate of rehabilitation therapy utilization over time in patients with PD using a nationwide cohort in Korea. Methods. Patients were identified using the registration code for PD in the program for rare, intractable disease from the National Health Insurance Service-National Sample Cohort database, which consists of 979,390 Korean residents. Data were divided into four periods: 2004–2006, 2007–2009, 2010–2012, and 2013–2015. We assessed the utilization of rehabilitation therapies and the associated patient characteristics. Results. The numbers of patients with PD were 384 in 2004, 855 in 2007, 1,023 in 2010, and 1,222 in 2013. The numbers of physiatrist visits per person were 0.58, 0.96, 1.97, and 2.91, in the respective periods. Among the patients, 35–40% had claims for physical therapy, 16–19% for occupational therapy, and 4–6% for swallowing therapy. There were no remarkable differences between these rates between the study periods. Sex, age, income, disability, and levodopa-equivalent dose were significantly associated with the utilization of rehabilitation therapy. Conclusion. This study demonstrated that the rate of rehabilitation therapy utilization did not change remarkably in patients with PD from 2004 to 2015 in Korea although the number of physiatrist visits increased dramatically. The present evidence and guidelines may have not been adequately integrated into clinical practice during the period of study. Additional efforts may be warranted to provide adequate rehabilitation therapies in clinical practice for patients with PD.

The use of dopamine agonists in newly diagnosed Parkinson's disease patients has changed

2014 ◽  
Vol 5 (5) ◽  
pp. 357-358
Author(s):  
H. Kuusisto ◽  
P. Hujanen ◽  
T. Mattila ◽  
T. Luukkaala ◽  
T. Keränen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonists ◽  
Newly Diagnosed

scholarly journals Trend of recognizing depression symptoms and antidepressants use in newly diagnosed Parkinson's disease: Population‐based study

2021 ◽  
Author(s):  
Khalid Orayj ◽  
Tahani Almeleebia ◽  
Easwaran Vigneshwaran ◽  
Sultan Alshahrani ◽  
Sirajudeen. S. Alavudeen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Population Based ◽  
Depression Symptoms ◽  
Newly Diagnosed ◽  
Population Based Study

scholarly journals Verbal memory is associated with structural hippocampal changes in newly diagnosed Parkinson's disease

2012 ◽  
Vol 84 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Mona K Beyer ◽  
Kolbjorn S Bronnick ◽  
Kristy S Hwang ◽  
Niels Bergsland ◽  
Ole Bjorn Tysnes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Verbal Memory ◽  
Newly Diagnosed

scholarly journals Predicting first fall in newly diagnosed Parkinson's disease: Insights from a fall-naïve cohort

2016 ◽  
Vol 31 (12) ◽  
pp. 1829-1836 ◽  
Author(s):  
Sue Lord ◽  
Brook Galna ◽  
Alison J. Yarnall ◽  
Shirley Coleman ◽  
David Burn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Newly Diagnosed

scholarly journals WHAT’S OLD IS NEW: USING ARTIFICIAL INTELLIGENCE TO ACCELERATE DISCOVERY OF NEW TREATMENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S16-S17
Author(s):  
Connie Marras ◽  
Laura C Maclagan ◽  
Yi Cheng ◽  
Naomi Visanji ◽  
Mina Tadrous ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Conditional Logistic Regression ◽  
Disease Diagnosis ◽  
Success Rates ◽  
Disease Modifying Drugs ◽  
Logistic Regression Models ◽  
Intelligence System ◽  
Disease Modifying

Abstract Given the high cost of drug development and low success rates, repurposing drugs already proven safe provides a promising avenue for identifying effective therapies with additional indications. The IBM Watson artificial intelligence system was used to search 1.3 million Medline abstracts to prioritize medications that may be potentially disease-modifying in Parkinson’s disease. We assessed patterns of use of the top 50 Watson-ranked drugs among 14,866 adults with Parkinson’s disease aged 70 and older who were matched to persons without Parkinson’s disease on age, sex, and comorbidity. Sociodemographic characteristics, chronic conditions, and use of other medications were compared using standardized differences. Patterns of potentially disease-modifying drug use were examined prior to and following ascertainment of Parkinson’s disease. Preliminary findings from multivariable conditional logistic regression models on the association between previous exposure to potentially disease-modifying drugs and Parkinson’s disease diagnosis will be presented.

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