Management of neuropsychiatric symptoms in long-term care residents with Parkinson's disease: a retrospective cohort study.
Identifieur interne : 001316 ( Ncbi/Merge ); précédent : 001315; suivant : 001317Management of neuropsychiatric symptoms in long-term care residents with Parkinson's disease: a retrospective cohort study.
Auteurs : Nathan Herrmann [Canada] ; Connie Marras ; Hadas D. Fischer ; Xuesong Wang ; Geoff M. Anderson ; Paula A. RochonSource :
- Drugs & aging [ 1179-1969 ] ; 2013.
English descriptors
- KwdEn :
- Aged, 80 and over, Antiparkinson Agents (therapeutic use), Cohort Studies, Drug Dosage Calculations, Drug Prescriptions (statistics & numerical data), Female, Humans, Levodopa (therapeutic use), Long-Term Care (psychology), Long-Term Care (statistics & numerical data), Male, Medication Adherence (statistics & numerical data), Neuropsychiatry, Parkinson Disease (drug therapy), Parkinson Disease (psychology), Retrospective Studies.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug therapy : Parkinson Disease.
- psychology : Long-Term Care, Parkinson Disease.
- statistics & numerical data : Drug Prescriptions, Long-Term Care, Medication Adherence.
- Aged, 80 and over, Cohort Studies, Drug Dosage Calculations, Female, Humans, Male, Neuropsychiatry, Retrospective Studies.
Abstract
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.
DOI: 10.1007/s40266-012-0038-8
PubMed: 23188751
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- to stream PubMed, to step Corpus: 000976
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pubmed:23188751Le document en format XML
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<author><name sortKey="Herrmann, Nathan" sort="Herrmann, Nathan" uniqKey="Herrmann N" first="Nathan" last="Herrmann">Nathan Herrmann</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. nathan.herrmann@sunnybrook.ca</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON</wicri:regionArea>
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<author><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name>
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<author><name sortKey="Fischer, Hadas D" sort="Fischer, Hadas D" uniqKey="Fischer H" first="Hadas D" last="Fischer">Hadas D. Fischer</name>
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<author><name sortKey="Wang, Xuesong" sort="Wang, Xuesong" uniqKey="Wang X" first="Xuesong" last="Wang">Xuesong Wang</name>
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<author><name sortKey="Anderson, Geoff M" sort="Anderson, Geoff M" uniqKey="Anderson G" first="Geoff M" last="Anderson">Geoff M. Anderson</name>
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<author><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A" last="Rochon">Paula A. Rochon</name>
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<author><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name>
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<author><name sortKey="Fischer, Hadas D" sort="Fischer, Hadas D" uniqKey="Fischer H" first="Hadas D" last="Fischer">Hadas D. Fischer</name>
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<series><title level="j">Drugs & aging</title>
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<term>Antiparkinson Agents (therapeutic use)</term>
<term>Cohort Studies</term>
<term>Drug Dosage Calculations</term>
<term>Drug Prescriptions (statistics & numerical data)</term>
<term>Female</term>
<term>Humans</term>
<term>Levodopa (therapeutic use)</term>
<term>Long-Term Care (psychology)</term>
<term>Long-Term Care (statistics & numerical data)</term>
<term>Male</term>
<term>Medication Adherence (statistics & numerical data)</term>
<term>Neuropsychiatry</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (psychology)</term>
<term>Retrospective Studies</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term>
<term>Levodopa</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Long-Term Care</term>
<term>Parkinson Disease</term>
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<term>Long-Term Care</term>
<term>Medication Adherence</term>
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<term>Cohort Studies</term>
<term>Drug Dosage Calculations</term>
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<term>Humans</term>
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<term>Neuropsychiatry</term>
<term>Retrospective Studies</term>
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<front><div type="abstract" xml:lang="en">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.</div>
</front>
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<DateCreated><Year>2013</Year>
<Month>01</Month>
<Day>18</Day>
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<DateCompleted><Year>2014</Year>
<Month>01</Month>
<Day>09</Day>
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<Month>05</Month>
<Day>29</Day>
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<Title>Drugs & aging</Title>
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<ArticleTitle>Management of neuropsychiatric symptoms in long-term care residents with Parkinson's disease: a retrospective cohort study.</ArticleTitle>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="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.</AbstractText>
<AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">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.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="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.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="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.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="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.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Herrmann</LastName>
<ForeName>Nathan</ForeName>
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<AffiliationInfo><Affiliation>Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. nathan.herrmann@sunnybrook.ca</Affiliation>
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<Author ValidYN="Y"><LastName>Marras</LastName>
<ForeName>Connie</ForeName>
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<Author ValidYN="Y"><LastName>Fischer</LastName>
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<Author ValidYN="Y"><LastName>Wang</LastName>
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<Author ValidYN="Y"><LastName>Anderson</LastName>
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