Dopamine agonist monotherapy utilization in patients with Parkinson’s disease
Objectives: To characterize patients with Parkinson’s disease (PD) who initiated dopamine agonist (DA) monotherapy, describe medication utilization and provider types, and estimate medication adherence and discontinuation rates. Methods: Retrospective study identified patients with PD in the Optum R...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Clinical Parkinsonism & Related Disorders |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590112522000445 |
| _version_ | 1827948425229893632 |
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| author | Monica Frazer Steve Arcona Lisa Le Rahul Sasane |
| author_facet | Monica Frazer Steve Arcona Lisa Le Rahul Sasane |
| author_sort | Monica Frazer |
| collection | DOAJ |
| description | Objectives: To characterize patients with Parkinson’s disease (PD) who initiated dopamine agonist (DA) monotherapy, describe medication utilization and provider types, and estimate medication adherence and discontinuation rates. Methods: Retrospective study identified patients with PD in the Optum Research Database and included those with ≥1 claim for DA or levodopa between 09/01/2012 and 12/31/2018, ≥2 PD diagnoses, commercial or Medicare Advantage Part D (MAPD) insurance, ≥40 years old, and continuous medical and pharmacy coverage ≥12 months before and after index date. A subset of patients receiving DA monotherapy was selected for this analysis. Variables were analyzed descriptively. Adherence was measured with medication possession ratio (MPR) and proportion of days covered (PDC); defined as ≥0.80. Results: Patients (N = 642) had mean (SD) age of 70.2 (9.9) years, 70.6 % had MAPD coverage, and 61.7 % were male. Neurologists prescribed 64.6 % of DA monotherapy, and 56.9 % of patients had ≥2 PD diagnoses before or on the index date. Index therapy was discontinued by 44.1 % of patients, and 55.9 % persisted for 12 months without change. Mean (SD) time to discontinuation was 102 (79) days. Mean (SD) MPR for patients (n = 562) with ≥2 fills was 0.84 (0.2); 70.3 % were MPR adherent. Mean (SD) PDC for all 642 patients was 0.66 (0.3); 50.5 % were PDC adherent. Conclusion: Adherence and continuation of therapy were suboptimal, which could translate into poor patient outcomes. Future studies could provide insights on the impact of low adherence and persistence with DA monotherapy. |
| first_indexed | 2024-04-09T12:54:02Z |
| format | Article |
| id | doaj.art-a7403977a7264ae58b331915b5389c34 |
| institution | Directory Open Access Journal |
| issn | 2590-1125 |
| language | English |
| last_indexed | 2024-04-09T12:54:02Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Parkinsonism & Related Disorders |
| spelling | doaj.art-a7403977a7264ae58b331915b5389c342023-05-14T04:29:27ZengElsevierClinical Parkinsonism & Related Disorders2590-11252023-01-018100173Dopamine agonist monotherapy utilization in patients with Parkinson’s diseaseMonica Frazer0Steve Arcona1Lisa Le2Rahul Sasane3QualityMetric, USACerevel Therapeutics, USAOptum HEOR, USA; Corresponding author at: Optum Life Sciences, 11000 Optum Circle, Eden Prairie, MN 55344, USA.Cerevel Therapeutics, USAObjectives: To characterize patients with Parkinson’s disease (PD) who initiated dopamine agonist (DA) monotherapy, describe medication utilization and provider types, and estimate medication adherence and discontinuation rates. Methods: Retrospective study identified patients with PD in the Optum Research Database and included those with ≥1 claim for DA or levodopa between 09/01/2012 and 12/31/2018, ≥2 PD diagnoses, commercial or Medicare Advantage Part D (MAPD) insurance, ≥40 years old, and continuous medical and pharmacy coverage ≥12 months before and after index date. A subset of patients receiving DA monotherapy was selected for this analysis. Variables were analyzed descriptively. Adherence was measured with medication possession ratio (MPR) and proportion of days covered (PDC); defined as ≥0.80. Results: Patients (N = 642) had mean (SD) age of 70.2 (9.9) years, 70.6 % had MAPD coverage, and 61.7 % were male. Neurologists prescribed 64.6 % of DA monotherapy, and 56.9 % of patients had ≥2 PD diagnoses before or on the index date. Index therapy was discontinued by 44.1 % of patients, and 55.9 % persisted for 12 months without change. Mean (SD) time to discontinuation was 102 (79) days. Mean (SD) MPR for patients (n = 562) with ≥2 fills was 0.84 (0.2); 70.3 % were MPR adherent. Mean (SD) PDC for all 642 patients was 0.66 (0.3); 50.5 % were PDC adherent. Conclusion: Adherence and continuation of therapy were suboptimal, which could translate into poor patient outcomes. Future studies could provide insights on the impact of low adherence and persistence with DA monotherapy.http://www.sciencedirect.com/science/article/pii/S2590112522000445Parkinson’s diseaseDopamine agonistDopamine agonist monotherapyAdherenceDiscontinuation ratesMedication utilization |
| spellingShingle | Monica Frazer Steve Arcona Lisa Le Rahul Sasane Dopamine agonist monotherapy utilization in patients with Parkinson’s disease Clinical Parkinsonism & Related Disorders Parkinson’s disease Dopamine agonist Dopamine agonist monotherapy Adherence Discontinuation rates Medication utilization |
| title | Dopamine agonist monotherapy utilization in patients with Parkinson’s disease |
| title_full | Dopamine agonist monotherapy utilization in patients with Parkinson’s disease |
| title_fullStr | Dopamine agonist monotherapy utilization in patients with Parkinson’s disease |
| title_full_unstemmed | Dopamine agonist monotherapy utilization in patients with Parkinson’s disease |
| title_short | Dopamine agonist monotherapy utilization in patients with Parkinson’s disease |
| title_sort | dopamine agonist monotherapy utilization in patients with parkinson s disease |
| topic | Parkinson’s disease Dopamine agonist Dopamine agonist monotherapy Adherence Discontinuation rates Medication utilization |
| url | http://www.sciencedirect.com/science/article/pii/S2590112522000445 |
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