Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based study
First line treatment for Parkinson’s disease (PD) is typically either L-dopa or a non-ergot dopamine agonist (DA). However, the options for the treatment of motor symptoms in PD patients have increased in the last thirty years, which have seen several new classes of PD medications introduced onto th...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-02-01
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| Series: | Saudi Pharmaceutical Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1319016421000153 |
| _version_ | 1818965789872488448 |
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| author | Khalid Orayj Ashley Akbari Arron Lacey Mathew Smith Owen Pickrell Emma L. Lane |
| author_facet | Khalid Orayj Ashley Akbari Arron Lacey Mathew Smith Owen Pickrell Emma L. Lane |
| author_sort | Khalid Orayj |
| collection | DOAJ |
| description | First line treatment for Parkinson’s disease (PD) is typically either L-dopa or a non-ergot dopamine agonist (DA). However, the options for the treatment of motor symptoms in PD patients have increased in the last thirty years, which have seen several new classes of PD medications introduced onto the market. The purpose of this study is to examine the changes in first line therapy of newly diagnosed Parkinson’s patients between 2000 and 2016 in Wales.A population-based study evaluated data from the Secure Anonymised Information Linkage (SAIL) Databank of residents in Wales, aged 40 years or older, newly treated with PD medications between 2000 and 2016. The data was compared across three intervals: 2000–2005, 2006–2011 and 2012–2016. Patients were classified by age at diagnosis into young: 40–60 years; mid, 61–80 years; and older >80 years. Logistic regression was undertaken to determine the predictors of PD medication prescribing.For the whole study period, the profiles of 9142 newly diagnosed PD patients were analysed. L-dopa was the most common first line therapy (80.6%), followed by non-ergot DAs (12.9%) and monoamine oxidase B (MAO-B) inhibitors (7.9%). Odds of L-dopa prescribing were greater in patients >80 years (OR = 20.46 95%CI: 16.25–25.76) and in the period 2012–2016 (OR = 1.98 95% CI: 1.70–2.29). Prescribing of non-ergot DAs significantly declined in 2012–2016 (OR = 0.42 95% CI: 0.35–0.49). Additional factors influencing first line therapy were deprivation, presence of diabetes and prior use of antidepressants. For example, PD patients residing in the least deprived area were less likely to be prescribed L-dopa compared to patients residing in the most deprived area (OR = 0.77 95% CI: 0.65–0.93).First line therapy in PD in Wales has undergone a significant switch towards L-dopa over the last 16 years. The data indicates reasonable compliance with guidelines on efficacy and safety issues related to Parkinson’s medications. |
| first_indexed | 2024-12-20T13:22:36Z |
| format | Article |
| id | doaj.art-a12193d253044f69a87458d7213167cb |
| institution | Directory Open Access Journal |
| issn | 1319-0164 |
| language | English |
| last_indexed | 2024-12-20T13:22:36Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Saudi Pharmaceutical Journal |
| spelling | doaj.art-a12193d253044f69a87458d7213167cb2022-12-21T19:39:22ZengElsevierSaudi Pharmaceutical Journal1319-01642021-02-01292206212Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based studyKhalid Orayj0Ashley Akbari1Arron Lacey2Mathew Smith3Owen Pickrell4Emma L. Lane5School of Pharmacy and Pharmaceutical Sciences, Cardiff University, CF10 3NB, United Kingdom; College of Pharmacy, King Khalid University, Guraiger, Abha 62529, Saudi Arabia; Corresponding author at: College of Pharmacy, King Khalid University, Abha, Saudi Arabia (K. Orayj).School of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, United KingdomSchool of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, United KingdomSchool of Pharmacy and Pharmaceutical Sciences, Cardiff University, CF10 3NB, United KingdomSchool of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, United KingdomSchool of Pharmacy and Pharmaceutical Sciences, Cardiff University, CF10 3NB, United KingdomFirst line treatment for Parkinson’s disease (PD) is typically either L-dopa or a non-ergot dopamine agonist (DA). However, the options for the treatment of motor symptoms in PD patients have increased in the last thirty years, which have seen several new classes of PD medications introduced onto the market. The purpose of this study is to examine the changes in first line therapy of newly diagnosed Parkinson’s patients between 2000 and 2016 in Wales.A population-based study evaluated data from the Secure Anonymised Information Linkage (SAIL) Databank of residents in Wales, aged 40 years or older, newly treated with PD medications between 2000 and 2016. The data was compared across three intervals: 2000–2005, 2006–2011 and 2012–2016. Patients were classified by age at diagnosis into young: 40–60 years; mid, 61–80 years; and older >80 years. Logistic regression was undertaken to determine the predictors of PD medication prescribing.For the whole study period, the profiles of 9142 newly diagnosed PD patients were analysed. L-dopa was the most common first line therapy (80.6%), followed by non-ergot DAs (12.9%) and monoamine oxidase B (MAO-B) inhibitors (7.9%). Odds of L-dopa prescribing were greater in patients >80 years (OR = 20.46 95%CI: 16.25–25.76) and in the period 2012–2016 (OR = 1.98 95% CI: 1.70–2.29). Prescribing of non-ergot DAs significantly declined in 2012–2016 (OR = 0.42 95% CI: 0.35–0.49). Additional factors influencing first line therapy were deprivation, presence of diabetes and prior use of antidepressants. For example, PD patients residing in the least deprived area were less likely to be prescribed L-dopa compared to patients residing in the most deprived area (OR = 0.77 95% CI: 0.65–0.93).First line therapy in PD in Wales has undergone a significant switch towards L-dopa over the last 16 years. The data indicates reasonable compliance with guidelines on efficacy and safety issues related to Parkinson’s medications.http://www.sciencedirect.com/science/article/pii/S1319016421000153Parkinson’s diseasePrescribing factorsSocial deprivationL-dopa |
| spellingShingle | Khalid Orayj Ashley Akbari Arron Lacey Mathew Smith Owen Pickrell Emma L. Lane Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based study Saudi Pharmaceutical Journal Parkinson’s disease Prescribing factors Social deprivation L-dopa |
| title | Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based study |
| title_full | Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based study |
| title_fullStr | Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based study |
| title_full_unstemmed | Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based study |
| title_short | Factors affecting the choice of first-line therapy in Parkinson’s disease patients in Wales: A population-based study |
| title_sort | factors affecting the choice of first line therapy in parkinson s disease patients in wales a population based study |
| topic | Parkinson’s disease Prescribing factors Social deprivation L-dopa |
| url | http://www.sciencedirect.com/science/article/pii/S1319016421000153 |
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