Impact of recommendations on the initial therapy of Parkinson's disease: a population-based study in France

Parkinsonism Relat Disord. 2011 Aug;17(7):543-6. doi: 10.1016/j.parkreldis.2011.04.020. Epub 2011 May 25.

Abstract

Levodopa induces long-term motor complications in Parkinson's disease (PD). Therapeutic strategies that prevent motor complications are needed. Our aim was to evaluate the impact of recommendations of a French consensus conference published in 2000 on initial PD therapy. We identified 308 PD patients as part of a population-based study performed within the Mutualité Sociale Agricole in five French districts (2007). Neurologists confirmed PD diagnosis. We compared initial therapy in 102 patients treated before 12/31/2000 to that of 206 patients treated afterwards. Initial treatment was in agreement with the recommendations if dopamine agonists were used in patients <60 years (n = 49) and levodopa in patients ≥70 years (n = 133). Agreement with the recommendations increased after 2000 (66.0%) compared to before (46.3%, p = 0.025). For patients <60 years, agreement increased (64.0% vs 20.2%, p = 0.017) while it remained stable (66.4% vs 70.6%, p = 0.73) in patients ≥70 years. The publication of recommendations has influenced initial treatment choices for PD in France.

MeSH terms

  • Aged
  • Antiparkinson Agents / therapeutic use*
  • Consensus Development Conferences as Topic
  • Dopamine Agonists / therapeutic use*
  • Female
  • France
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Levodopa / therapeutic use*
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*

Substances

  • Antiparkinson Agents
  • Dopamine Agonists
  • Levodopa