Pharmaceutical Policy Research Team, Health Insurance Review and Assessment Service, Wonju, Korea.
College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea.
Yonsei Med J. 2019 Aug;60(8):760-767. doi: 10.3349/ymj.2019.60.8.760.
Discontinuation of offending drugs can prevent drug-induced parkinsonism (DIP) before it occurs and reverse or cure it afterwards. The aim of this study was to investigate the prevalence of DIP and the utilization of offending drugs through an analysis of representative nationwide claims data.
We selected DIP patients of ages ranging from 40 to 100 years old with the G21.1 code from the Korean National Service Health Insurance Claims database from 2009 to 2015. The annual standardized prevalence of DIP was explored from 2009 to 2015. Trends were estimated using the compound annual growth rate (CAGR) and the Cochran-Armitage test for DIP over the course of 6 years. Additionally, the utilization of offending drugs was analyzed.
The annual prevalence of DIP was 4.09 per 100000 people in 2009 and 7.02 in 2015 (CAGR: 9.42%, <0.001). Levosulpiride use before and after DIP diagnosis showed a clear trend for decreasing utilization (CAGR: -5.4%, -4.3% respectively), whereas the CAGR for itopride and metoclopramide increased by 12.7% and 6.4%, respectively. In 2015, approximately 46.6% (858/1840 persons) of DIP patients were prescribed offending drugs after DIP diagnosis. The most commonly prescribed causative drug after DIP diagnosis was levosulpiride.
The prevalence of DIP has increased. To prevent or decrease DIP, we suggest that physicians reduce prescriptions of benzamide derivatives that have been most commonly used, and that attempts be made to find other alternative drugs. Additionally, the need for continuing education about offending drugs should be emphasized.
在药物引起的帕金森病(DIP)发生之前停止使用致病药物,可以预防 DIP 的发生,并在之后逆转或治愈它。本研究的目的是通过分析具有代表性的全国性索赔数据来调查 DIP 的患病率和致病药物的使用情况。
我们从 2009 年至 2015 年的韩国国家健康保险索赔数据库中选择了年龄在 40 至 100 岁之间的 G21.1 代码的 DIP 患者。从 2009 年至 2015 年,我们探讨了 DIP 的年标准化患病率。使用复合年增长率(CAGR)和 Cochran-Armitage 检验,对 6 年内 DIP 的趋势进行了估计。此外,还分析了致病药物的使用情况。
2009 年 DIP 的年患病率为每 100000 人 4.09 例,2015 年为 7.02 例(CAGR:9.42%,<0.001)。在 DIP 诊断前后,左舒必利的使用呈现出明显的下降趋势(CAGR:-5.4%,-4.3%),而伊托必利和甲氧氯普胺的 CAGR 分别增加了 12.7%和 6.4%。2015 年,大约 46.6%(858/1840 人)的 DIP 患者在 DIP 诊断后开了致病药物。在 DIP 诊断后,最常开的致病药物是左舒必利。
DIP 的患病率有所增加。为了预防或减少 DIP,我们建议医生减少最常用的苯甲酰胺衍生物的处方,并尝试寻找其他替代药物。此外,应强调对致病药物进行继续教育的必要性。