Bazán-Rodríguez Lisette, Cervantes-Arriaga Amin, Llorens-Arenas Rodrigo, Calderón-Fajardo Humberto, Rodríguez-Violante Mayela
Neurodegenerative Disease Clinical Research Unit National Institute of Neurology and Neurosurgery Mexico City Mexico.
Movement Disorder Clinic National Institute of Neurology and Neurosurgery Mexico City Mexico.
Mov Disord Clin Pract. 2015 Oct 28;3(1):68-72. doi: 10.1002/mdc3.12226. eCollection 2016 Jan-Feb.
Pharmacological management of subjects with Parkinson's disease (PD) is complex. Regardless of drug selection, adherence is one of the main concerns. Nonadherence is associated with poor symptomatic control and low quality of life. In general, adherence to once-a-day formulations is thought to be better in comparison to 3-times-daily dosing.
A cross-sectional study was carried out. Consecutive uninsured subjects diagnosed with PD were treated either with an immediate- or extended-release dopamine agonist formulation. Clinical and demographic data were collected. Subjects were assessed using the International Parkinson and Movement Disorder Society UPDRS. Adherence was evaluated using the Morisky-Green test (MGT).
A total of 314 (175 males and 139 females) subjects with PD were included. In regard to treatment, 188 (59.9%) were on an immediate-release dopamine agonist and 126 (40.1%) on an extended-release dopamine agonist. According to the MGT, 21 (6.7%) subjects were classified as nonadherent, 273 (86.9%) with a low adherence, and only 20 (6.4%) were considered with high adherence. Dopamine agonist levodopa equivalent daily dose was higher in the extended-release group (296.6 ± 112.4 vs. 231.3 ± 133.4; = 0.011); also, these subjects had more years of formal education (12.3 ± 5.2 vs. 9.5 ± 5.2; = 0.630). No difference in adherence levels was found ( = 0.802) between subjects treated with an immediate-release dopamine agonist and those receiving an extended-release formulation.
Overall adherence in subjects with PD is low. Use of an extended-release over an immediate-release dopamine agonist formulation in this study population is not associated with a better adherence.
帕金森病（PD）患者的药物治疗较为复杂。无论药物如何选择，依从性都是主要问题之一。不依从与症状控制不佳和生活质量低下有关。一般来说，与每日三次给药相比，每日一次剂型的依从性被认为更好。
进行了一项横断面研究。连续纳入未参保的PD诊断患者，给予速释或缓释多巴胺激动剂制剂治疗。收集临床和人口统计学数据。使用国际帕金森和运动障碍协会统一帕金森病评定量表（UPDRS）对患者进行评估。使用莫利斯基-格林测试（MGT）评估依从性。
共纳入314例PD患者（175例男性和139例女性）。在治疗方面，188例（59.9%）使用速释多巴胺激动剂，126例（40.1%）使用缓释多巴胺激动剂。根据MGT，21例（6.7%）患者被归类为不依从，273例（86.9%）依从性低，只有20例（6.4%）被认为依从性高。缓释组多巴胺激动剂左旋多巴等效日剂量更高（296.6±112.4对231.3±133.4；P=0.011）；此外，这些患者接受正规教育的年限更多（12.3±5.2对9.5±5.2；P=0.630）。速释多巴胺激动剂治疗的患者与接受缓释制剂治疗的患者之间在依从性水平上未发现差异（P=0.802）。
PD患者的总体依从性较低。在本研究人群中，使用缓释多巴胺激动剂制剂而非速释制剂与更好的依从性无关。
