Department of Medicine, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand ; New Zealand Brain Research Institute, 66 Stewart Street, Christchurch 8011, New Zealand.
Department of Medicine, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand ; New Zealand Brain Research Institute, 66 Stewart Street, Christchurch 8011, New Zealand ; Department of Neurology, Canterbury District Health Board, Private Bag 4710, Christchurch 8140, New Zealand.
Parkinsons Dis. 2014;2014:379431. doi: 10.1155/2014/379431. Epub 2014 Mar 4.
Prescribing trends for medications are influenced by development of new drugs, changes in knowledge about efficacy and side effects, and priorities set by funding agencies. Changes in the utilization of antiparkinsonian agents in the outpatient community in New Zealand were investigated by using the national prescription database for the period 1995-2011. The dispensed volumes of antiparkinsonian agents were converted into number of defined daily doses per 1000 inhabitants per day for analysis. Increases in the dispensed volumes of levodopa (77%), amantadine (350%), and catechol-o-methyl transferase inhibitors (326%) occurred during the study period. Conversely, decreases in the dispensed volumes of anticholinergics (48%), selegiline (82%), and dopamine agonists (6.2%) were observed. New Zealand has seen a substantial increase of the amount of levodopa dispensed in the past 17 years. This increase appears to be related to an increase in the number of people taking the medication. We are unable to extrapolate this change to an increase in the prevalence of PD, given levodopa is used in the treatment of a number of medical conditions. The changes in other antiparkinsonian medications largely reflect changes in availability (increases in entacapone and ropinirole) and best practice treatment (declines in anticholinergics, selegiline, and tolcapone).
药物的处方趋势受到新药的发展、对疗效和副作用的认识变化以及资助机构设定的优先事项的影响。通过使用 1995 年至 2011 年的国家处方数据库，研究了新西兰社区门诊中抗帕金森病药物的使用变化。将抗帕金森病药物的配发量转换为每 1000 居民每天的规定日剂量数进行分析。在研究期间，左旋多巴（77%）、金刚烷胺（350%）和儿茶酚-O-甲基转移酶抑制剂（326%）的配发量增加。相反，抗胆碱能药物（48%）、司来吉兰（82%）和多巴胺激动剂（6.2%）的配发量减少。在过去的 17 年中，新西兰左旋多巴的配发量大幅增加。这种增加似乎与服用这种药物的人数增加有关。鉴于左旋多巴用于治疗多种疾病，我们无法将这种变化推断为 PD 患病率的增加。其他抗帕金森病药物的变化在很大程度上反映了可用性的变化（恩他卡朋和罗匹尼罗的增加）和最佳治疗实践（抗胆碱能药物、司来吉兰和托卡朋的减少）。
