Effect of Parkinson's disease treatment guideline on medicine treatment / 中华老年医学杂志

ABSTRACT

Objective To evaluate the effect of Parkinson's disease treatment guideline on the initial medicine therapy and to explore the impact of hospital grade level and type of insurance on the initial prescription for Parkinson's disease.Methods We identified 136 PD patients as part of a population-based study in Beijing and made a comparison between the patients with initial prescriptions of dopamine receptor agonists (DA) and levodopa (LD).Results Among 136 patients,excluding patients without initial medication of levodopa or dopamine receptor agonist,there were 61 cases with initial drug administration aged ≥ 65 years.Among the 61 cases,1 cases and 19 cases administrated dopamine receptor agonist and levodopa respectively before 2006,1 case and 11 cases respectively from 2007 to 2009,and 5 cases and 24 cases respectively after 2010.There was no significant difference in the percentage between patients with initial administration of levodopa and dopamine receptor agonist in the three periods (x2 =1.891,P =0.388).In 41 patients with initial drug administration of dopamine receptor agonist or levodopa aged＜65 years,1 cases and 23 cases administrated dopamine receptor agonist or levodopa respectively before 2006,0 case and 10 cases respectively from 2007 to 2009,and 3 cases and 4 cases respectively after 2010.There was significant differences in the percentage between patients with initial administration of levodopa and dopamine receptor agonist in the three periods (x2 =10.644,P=0.005).The percentage of patients with initial administration of dopamine receptor agonist aged＜65 years was increased after 2010 as compared before 2006 (x2 =7.219,P=0.028).There were no significant differences in the percentage of patients with initial administration of dopamine receptor agonist between grade 3 and non-grade 3 hospitals (13.6％ vs.6.3％,x2=0.675,P=0.686)and between patients with and without insurance (13.1％ vs.10.0％,x2=0.141,P=1.000).Conclusions The percentage of patients with initial administration of levodopa and dopamine receptor agonist has no significant difference between patients with initial drug administration aged ≥ 65 years before and after the introduction of Parkinson's disease treatment guideline,while the percentage is increased in patients with initial drug administration aged＜65 years.No impact of hospital grade level and type of insurance on initial administration for Parkinson's disease is found.