1Senior Resident, Department of Neurology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India 2Professor Emeritus, Department of Neurology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India 3Professor and Head, Department of Neurology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
Background: Idiopathic Parkinson’s Disease (IPD) is one of the most common neurodegenerative movement disorders having a constellation of motor as well as non-motor symptoms. The treatment of IPD has few common drugs however the prescription patterns and treatment protocols vary between different hospitals as well as physicians. The purpose of the current study was to assess and analyse the prescription patterns regarding IPD.
Materials and Methods: Type: Ambispective (retrospective and prospective) study. Sample size: 150. Patients duration: 2018 to 2023. Inclusion criteria: 1) Patients fulfilling the criteria for Idiopathic Parkinson Disease, 2) Willingness of patients to participate in the study. Exclusion criteria: 1) Patients not fulfilling the criteria for idiopathic Parkinson disease, 2) Secondary and Atypical PD, 3) Patients not willing to participate in the study. One prescription was analysed per patient. Prescriptions from outside and within the hospital were included. The first prescription was taken into account in all the patients for uniformity. Along with the prescriptions, demographic and clinical profile was taken into account. The data was entered in MS Excel and results were analysed using SPSS 20.
Results: Mean age of patients was 57.3 years. 89 (59.33%) were males and 61 (40.67%) were females. The Mean age of onset of the disease was 52.9 years and the mean duration of the disease was 3.21 years. Mean UPDRS score was 68.88. 59 (39.33%) patients were in stage 1 - 1.5 Modified Hoehn and Yahr scale, 46 (30.67%) patients had stage 2 - 2.5, 29 (19.33%) in stage 3, 13 (8.6%) in stage 4 and 3 (2%) patients in stage 5. Out of 150 patients, 12 (8%) patients were on monotherapy. 68 (45.33%) patients were on dual therapy. 43 (28.67%) patients were triple drug therapy and 27 (18%) were on polytherapy. 82.4% patients were on medication prescribed from neurologist or movement disorder specialist whereas rest of the prescriptions from general physicians.
Conclusion: There is a trend of prescription of dopaminergic agonists and levodopa as monotherapy. Novel agents like Levodopa intestinal gel or apomorphine are not being used. While prescribing factors like age of onset, duration of illness, motor or non-motor symptoms, dyskinesias, cognitive decline, tolerance to medicines and last but not the least affordability and availability should be taken into account while prescribing treatment to patients with Parkinson disease.
Keywords: Idiopathic Parkinson’s Disease (IPD); Movement Disorders; Dyskinesias; Cognitive Decline
Himanshu Kaushal., et al. “Prescription Patterns in Patients with Idiopathic Parkinson’s Disease: An Ambispective Study from Northern Rajasthan of Indian Subcontinent”. EC Neurology 16.2 (2024): 01-05.
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