College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, 41566, Republic of Korea.
College of Natural Science, Kyungpook National University, Daegu, 41566, Republic of Korea.
Drug Saf. 2017 Nov;40(11):1109-1118. doi: 10.1007/s40264-017-0559-5.
Published studies on the association between polypharmacy and parkinsonism or Parkinson disease are very limited.
The objective of this study was to investigate whether polypharmacy is associated with parkinsonism or Parkinson disease in elderly patients.
From a South Korean national health insurance sample cohort database for 2002-2013, we matched parkinsonism cases (defined by diagnosis codes for parkinsonism/Parkinson disease) and Parkinson disease cases (patients who had records for both Parkinson disease diagnosis and anti-Parkinson disease drug prescriptions) with controls. Logistic regression analysis evaluated the associations of parkinsonism/Parkinson disease with polypharmacy (i.e., five or more prescribed daily drugs) during the year preceding parkinsonism/Parkinson disease diagnosis, medications potentially associated with parkinsonism, and comorbidity status (using the Charlson Comorbidity Index score and hospitalization records).
The study population included 6209 cases and 24,836 controls for parkinsonism and 1331 cases and 5324 controls for Parkinson disease. In univariate logistic regression, odds ratios for parkinsonism/Parkinson disease increased significantly with increased polypharmacy, medications potentially associated with parkinsonism, Charlson Comorbidity Index score, or prior hospitalizations. In multiple logistic regression, odds ratios for parkinsonism/Parkinson disease (adjusted for medications potentially associated with parkinsonism and comorbidities) also increased with increased polypharmacy. Odds ratios (95% confidence interval) for Parkinson disease were higher than those for parkinsonism with stronger statistical significance: 1.41 (1.28-1.55) and 2.17 (1.84-2.57) for parkinsonism and 2.87 (2.30-3.58) and 4.75 (3.39-6.66) for Parkinson disease for between five and ten prescribed daily drugs and ten or more drugs, respectively.
Polypharmacy in the year preceding diagnosis may be associated with an increased risk for parkinsonism/Parkinson disease. Medications potentially associated with parkinsonism were assumed to increase the risk for parkinsonism/Parkinson disease, but more studies are required to confirm this relationship.
有关药物滥用与帕金森病或帕金森病之间关联的已发表研究非常有限。
本研究旨在调查老年患者中药物滥用是否与帕金森病或帕金森病有关。
我们从 2002 年至 2013 年的韩国国家健康保险样本队列数据库中，将帕金森病病例（通过帕金森病/帕金森病的诊断代码定义）和帕金森病病例（同时有帕金森病诊断记录和抗帕金森病药物处方的患者）与对照组相匹配。使用逻辑回归分析评估了帕金森病/帕金森病与一年前帕金森病/帕金森病诊断前的药物滥用（即，五种或更多种规定的每日药物）、可能与帕金森病相关的药物以及合并症状况（使用 Charlson 合并症指数评分和住院记录）之间的关联。
研究人群包括帕金森病的 6209 例病例和 24836 例对照，以及帕金森病的 1331 例病例和 5324 例对照。在单变量逻辑回归中，帕金森病/帕金森病的优势比随着药物滥用的增加、可能与帕金森病相关的药物、Charlson 合并症指数评分或先前住院次数的增加而显著增加。在多变量逻辑回归中，帕金森病/帕金森病的优势比（调整可能与帕金森病相关的药物和合并症）也随着药物滥用的增加而增加。与帕金森病相比，帕金森病的优势比（95%置信区间）具有更高的统计学意义：在使用五种或更多种规定的每日药物和十种或更多种药物时，帕金森病的优势比分别为 1.41（1.28-1.55）和 2.17（1.84-2.57），而帕金森病的优势比分别为 2.87（2.30-3.58）和 4.75（3.39-6.66）。
诊断前一年的药物滥用可能与帕金森病/帕金森病的风险增加有关。假设可能与帕金森病相关的药物会增加帕金森病/帕金森病的风险，但需要更多的研究来证实这种关系。
