Management of Neuropsychiatric Symptoms in Long-Term Care Residents with Parkinson's Disease: A Retrospective Cohort Study
Identifieur interne : 001060 ( Main/Exploration ); précédent : 001059; suivant : 001061Management of Neuropsychiatric Symptoms in Long-Term Care Residents with Parkinson's Disease: A Retrospective Cohort Study
Auteurs : Nathan Herrmann [Canada] ; Connie Marras [Canada] ; Hadas D. Fischer [Canada] ; XUESONG WANG [Canada] ; Geoff M. Anderson [Canada] ; Paula A. Rochon [Canada]Source :
- Drugs & aging [ 1170-229X ] ; 2013.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Santé publique, Homme, Personne âgée.
English descriptors
- KwdEn :
Abstract
Background The management of neuropsychiatric symptoms, including psychosis, in Parkinson's Disease (PD) is complicated by the fact that treatment with antipsychotics can worsen the movement disorder, which may necessitate changes to antiparkinsonian medications. Objectives The objectives of this study were to determine what antipsychotics are prescribed to residents in long-term care with PD and document subsequent changes in levodopa dosage. Methods A retrospective cohort study using administrative health database information from Ontario, Canada, was conducted. PD diagnostic codes were obtained from the Ontario Health Insurance Plan (physician diagnostic codes) and the Canadian Institute of Health Information (hospitalization discharge diagnoses). The Ontario Drug Benefit database provided information on the use of antiparkinsonian medications and antipsychotics. Residents diagnosed with PD in long-term care were included if they were treated with stable doses of levodopa monotherapy and received a new prescription for an antipsychotic. The type of antipsychotic and the changes in levodopa dosage were determined. Results There were 479 residents who met inclusion criteria. The prescribed antipsychotics were quetiapine (n = 192; 40 %), risperidone (n = 185; 39 %) and olanzapine (n = 81; 17 %), and only 21 (4 %) received a prescription for a typical antipsychotic. The first levodopa dosage change was a dose reduction in 469 (98 %) patients, and a dose increase in ten (2 %) patients. Conclusions Many PD patients in long-term care are treated with potentially inappropriate antipsychotic medications. However, there is no evidence that this treatment results in a prescribing cascade that leads to inappropriate increases in levodopa dosage.
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: 000119
- to stream PascalFrancis, to step Curation: 000B13
- to stream PascalFrancis, to step Checkpoint: 000069
- to stream Main, to step Merge: 001076
- to stream Main, to step Curation: 001060
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Management of Neuropsychiatric Symptoms in Long-Term Care Residents with Parkinson's Disease: A Retrospective Cohort Study</title><author><name sortKey="Herrmann, Nathan" sort="Herrmann, Nathan" uniqKey="Herrmann N" first="Nathan" last="Herrmann">Nathan Herrmann</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue</s1><s2>Toronto, ON M4N 3M5</s2><s3>CAN</s3><sZ>1 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON M4N 3M5</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Toronto Western Hospital Movement Disorders Centre, University of Toronto and the Edmond J. Safra Program in Parkinson's Research</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON</wicri:noRegion></affiliation></author><author><name sortKey="Fischer, Hadas D" sort="Fischer, Hadas D" uniqKey="Fischer H" first="Hadas D." last="Fischer">Hadas D. Fischer</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation></author><author><name sortKey="Xuesong Wang" sort="Xuesong Wang" uniqKey="Xuesong Wang" last="Xuesong Wang">XUESONG WANG</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Geoff M" sort="Anderson, Geoff M" uniqKey="Anderson G" first="Geoff M." last="Anderson">Geoff M. Anderson</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Institute of Health Policy, Management and Evaluation, University of Toronto</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Women's College Research Institute, Women's College Hospital</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON</wicri:noRegion></affiliation></author><author><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Institute of Health Policy, Management and Evaluation, University of Toronto</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Women's College Research Institute, Women's College Hospital</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>Department of Medicine, University of Toronto</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">13-0059329</idno><date when="2013">2013</date><idno type="stanalyst">PASCAL 13-0059329 INIST</idno><idno type="RBID">Pascal:13-0059329</idno><idno type="wicri:Area/PascalFrancis/Corpus">000119</idno><idno type="wicri:Area/PascalFrancis/Curation">000B13</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000069</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000069</idno><idno type="wicri:doubleKey">1170-229X:2013:Herrmann N:management:of:neuropsychiatric</idno><idno type="wicri:Area/Main/Merge">001076</idno><idno type="wicri:Area/Main/Curation">001060</idno><idno type="wicri:Area/Main/Exploration">001060</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Management of Neuropsychiatric Symptoms in Long-Term Care Residents with Parkinson's Disease: A Retrospective Cohort Study</title><author><name sortKey="Herrmann, Nathan" sort="Herrmann, Nathan" uniqKey="Herrmann N" first="Nathan" last="Herrmann">Nathan Herrmann</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue</s1><s2>Toronto, ON M4N 3M5</s2><s3>CAN</s3><sZ>1 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON M4N 3M5</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Toronto Western Hospital Movement Disorders Centre, University of Toronto and the Edmond J. Safra Program in Parkinson's Research</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON</wicri:noRegion></affiliation></author><author><name sortKey="Fischer, Hadas D" sort="Fischer, Hadas D" uniqKey="Fischer H" first="Hadas D." last="Fischer">Hadas D. Fischer</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation></author><author><name sortKey="Xuesong Wang" sort="Xuesong Wang" uniqKey="Xuesong Wang" last="Xuesong Wang">XUESONG WANG</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Geoff M" sort="Anderson, Geoff M" uniqKey="Anderson G" first="Geoff M." last="Anderson">Geoff M. Anderson</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Institute of Health Policy, Management and Evaluation, University of Toronto</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Women's College Research Institute, Women's College Hospital</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON</wicri:noRegion></affiliation></author><author><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Institute of Health Policy, Management and Evaluation, University of Toronto</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Women's College Research Institute, Women's College Hospital</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, ON</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>Department of Medicine, University of Toronto</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author></analytic><series><title level="j" type="main">Drugs & aging</title><title level="j" type="abbreviated">Drugs aging</title><idno type="ISSN">1170-229X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Drugs & aging</title><title level="j" type="abbreviated">Drugs aging</title><idno type="ISSN">1170-229X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical management</term><term>Cohort study</term><term>Elderly</term><term>Human</term><term>Long term care</term><term>Mental disorder</term><term>Parkinson disease</term><term>Public health</term><term>Resident</term><term>Retrospective</term><term>Review</term><term>Symptomatology</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Conduite à tenir</term><term>Trouble psychiatrique</term><term>Symptomatologie</term><term>Soins de longue durée</term><term>Résident</term><term>Maladie de Parkinson</term><term>Rétrospective</term><term>Santé publique</term><term>Homme</term><term>Etude cohorte</term><term>Article synthèse</term><term>Personne âgée</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Santé publique</term><term>Homme</term><term>Personne âgée</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background The management of neuropsychiatric symptoms, including psychosis, in Parkinson's Disease (PD) is complicated by the fact that treatment with antipsychotics can worsen the movement disorder, which may necessitate changes to antiparkinsonian medications. Objectives The objectives of this study were to determine what antipsychotics are prescribed to residents in long-term care with PD and document subsequent changes in levodopa dosage. Methods A retrospective cohort study using administrative health database information from Ontario, Canada, was conducted. PD diagnostic codes were obtained from the Ontario Health Insurance Plan (physician diagnostic codes) and the Canadian Institute of Health Information (hospitalization discharge diagnoses). The Ontario Drug Benefit database provided information on the use of antiparkinsonian medications and antipsychotics. Residents diagnosed with PD in long-term care were included if they were treated with stable doses of levodopa monotherapy and received a new prescription for an antipsychotic. The type of antipsychotic and the changes in levodopa dosage were determined. Results There were 479 residents who met inclusion criteria. The prescribed antipsychotics were quetiapine (n = 192; 40 %), risperidone (n = 185; 39 %) and olanzapine (n = 81; 17 %), and only 21 (4 %) received a prescription for a typical antipsychotic. The first levodopa dosage change was a dose reduction in 469 (98 %) patients, and a dose increase in ten (2 %) patients. Conclusions Many PD patients in long-term care are treated with potentially inappropriate antipsychotic medications. However, there is no evidence that this treatment results in a prescribing cascade that leads to inappropriate increases in levodopa dosage.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Herrmann, Nathan" sort="Herrmann, Nathan" uniqKey="Herrmann N" first="Nathan" last="Herrmann">Nathan Herrmann</name></region><name sortKey="Anderson, Geoff M" sort="Anderson, Geoff M" uniqKey="Anderson G" first="Geoff M." last="Anderson">Geoff M. Anderson</name><name sortKey="Anderson, Geoff M" sort="Anderson, Geoff M" uniqKey="Anderson G" first="Geoff M." last="Anderson">Geoff M. Anderson</name><name sortKey="Anderson, Geoff M" sort="Anderson, Geoff M" uniqKey="Anderson G" first="Geoff M." last="Anderson">Geoff M. Anderson</name><name sortKey="Fischer, Hadas D" sort="Fischer, Hadas D" uniqKey="Fischer H" first="Hadas D." last="Fischer">Hadas D. Fischer</name><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><name sortKey="Xuesong Wang" sort="Xuesong Wang" uniqKey="Xuesong Wang" last="Xuesong Wang">XUESONG WANG</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Canada/explor/ParkinsonCanadaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001060 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 001060 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Canada
|area= ParkinsonCanadaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= Pascal:13-0059329
|texte= Management of Neuropsychiatric Symptoms in Long-Term Care Residents with Parkinson's Disease: A Retrospective Cohort Study
}}
| This area was generated with Dilib version V0.6.29. |  |