Difference in rural and urban Medicare prescription pattern for Parkinson’s disease in Hawai‘i

Bruno, Michiko Kimura; Watanabe, Gina; Gao, Fay; Seto, Todd B.; Nakagawa, Kazuma; Trinacty, Connie Mah; Brown, Stacy; Taira, Deborah A.

doi:10.1016/j.prdoa.2022.100144

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…In contrast, in rural areas, 74.9% of the prescriptions were written by general practitioners. In the latter, levodopa was prescribed to 43.1% of individuals, a figure like what has been reported in Africa 2,7 . Ethnicity is another factor accounting for disparities in care.…”

Section: Figurementioning

confidence: 59%

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Difficulties of Access to Diagnostic Methods and Therapies in Movement Disorders: A Call to Action

Cardoso

2023

Movement Disord Clin Pract

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Section: Figurementioning

confidence: 59%

“…In the latter, levodopa was prescribed to 43.1% of individuals, a figure like what has been reported in Africa. 2,7 Ethnicity is another factor accounting for disparities in care. In the United Kingdom, 83% of people with PD experiencing pain received pain relief.…”

mentioning

confidence: 99%

Difficulties of Access to Diagnostic Methods and Therapies in Movement Disorders: A Call to Action

Cardoso

2023

Movement Disord Clin Pract

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Dopaminergic treatment strategies for people with Parkinson’s disease in Europe: a retrospective analysis of PRISM trial data

et al. 2023

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Background Levodopa (LD) is the most effective drug to treat Parkinson’s disease (PD). The recently concluded multinational Parkinson’s Real-World Impact Assessment (PRISM) trial revealed highly variable prescription patterns of LD monotherapy across six European countries. The reasons remain unclear. Methods In this post hoc analysis of PRISM trial data, we used multivariate logistic regression analysis to identify socio-economic factors affecting prescription practice. We applied receiver-operated characteristics and split sample validation to test model accuracy to predict treatment class (LD monotherapy vs. all other treatments). Results Subject age, disease duration, and country of residence were significant predictors of treatment class. The chance of receiving LD monotherapy increased by 6.9% per year of age. In contrast, longer disease duration reduced the likelihood of receiving LD monotherapy by 9.7% per year. Compared to the other countries, PD patients in Germany were 67.1% less likely and their counterparts in the UK 86.8% more likely to receive an LD monotherapy. The model classification accuracy of treatment class assignment was 80.1%. The area under the curve to predict treatment condition was 0.758 (95% CI [0.715, 0.802]). Split sample validation revealed poor sensitivity (36.6%), but excellent specificity (92.7%) to predict treatment class. Conclusion The relative lack of socio-economic variables affecting prescription practice in the study sample and limited model accuracy to predict treatment class suggest the presence of additional, country-specific factors affecting prescription patterns that were not assessed in the PRISM trial. Our findings indicate that physicians still avoid prescribing LD monotherapy to younger PD patients.

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Difference in rural and urban Medicare prescription pattern for Parkinson’s disease in Hawai‘i

Cited by 2 publications

References 30 publications

Difficulties of Access to Diagnostic Methods and Therapies in Movement Disorders: A Call to Action

Difficulties of Access to Diagnostic Methods and Therapies in Movement Disorders: A Call to Action

Dopaminergic treatment strategies for people with Parkinson’s disease in Europe: a retrospective analysis of PRISM trial data

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