Leoni Olivia, Martignoni Emilia, Cosentino Marco, Michielotto Donatella, Calandrella Daniela, Zangaglia Roberta, Riboldazzi Giulio, Oria Cristina, Lecchini Sergio, Nappi Giuseppe, Frigo Gianmario
Center for Research in Clinical and Applied Pharmacology, Laboratory of Pharmacology, University of Insubria and University of Pavia, Varese, Italy.
Pharmacoepidemiol Drug Saf. 2002 Mar;11(2):149-57. doi: 10.1002/pds.682.
Drug treatment of idiopathic Parkinson's disease (IPD) is a difficult task, and comorbidity and comedication add to its complexity. Since in IPD there is little information about drug use, this study investigated drug prescribing and indications in IPD patients.
From June 1997 to April 1998, a cross-sectional survey of IPD outpatients was performed and demographic and clinical data and information about drug treatments was collected and analysed.
In the 130 IPD patients included in the study, anti-Parkinson drug (APD) prescriptions increased with disease duration and severity. Levodopa was most frequently used, followed by dopamine agonists and anticholinergic agents. Levodopa with other APDs was given to older patients with later IPD onset. Prescriptions of drugs for other indications (non-APDs) were given to 80.8% of the patients and their number increased with patient age. Non-APD prescriptions concerned mainly the circulatory system, mental disorders, the musculoskeletal system and the digestive system. Prescriptions for indications corresponding to secondary symptoms that often complicate IPD increased with patient age and also with IPD duration.
In IPD patients, disease duration and severity and patient age seem to be major determinants of drug use. Indications for drug prescription suggest that main comorbidity includes neuropsychiatric, circulatory, musculoskeletal and digestive disorders. Analysis of prescribing patterns in IPD can provide a readily accessible indirect indicator of patient health status for both health services and epidemiologic research purposes.
特发性帕金森病（IPD）的药物治疗是一项艰巨的任务，合并症和联合用药使其更加复杂。由于IPD患者用药信息较少，本研究调查了IPD患者的药物处方及用药指征。
1997年6月至1998年4月，对IPD门诊患者进行横断面调查，收集并分析人口统计学、临床数据及药物治疗信息。
纳入研究的130例IPD患者中，抗帕金森药物（APD）处方随病程和病情严重程度增加。左旋多巴使用最为频繁，其次是多巴胺激动剂和抗胆碱能药物。左旋多巴与其他APD联合用于发病较晚的老年患者。80.8%的患者开具了用于其他指征（非APD）的药物，且其数量随患者年龄增加。非APD处方主要涉及循环系统、精神障碍、肌肉骨骼系统和消化系统。与IPD常见并发症相关的继发症状的用药指征处方随患者年龄和IPD病程增加。
在IPD患者中，病程、病情严重程度和患者年龄似乎是药物使用的主要决定因素。药物处方指征表明主要合并症包括神经精神、循环、肌肉骨骼和消化系统疾病。对IPD处方模式的分析可为卫生服务和流行病学研究提供一个易于获取的患者健康状况间接指标。
