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KMID : 0370220190630060333
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Yakhak Hoeji
2019 Volume.63 No. 6 p.333 ~ p.340
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Current Status and Factors Affecting Prescription of Gastrointestinal Motility Drugs in Patients with Parkinson’s Disease
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Lee Chang-Hoon
Kim Si-In
Suh Hae-Sun
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Abstract
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Gastrointestinal motility drugs have been prescribed to manage functional dyspepsia in Parkinson’s disease(PD). However, anti-dopaminergic gastrointestinal motility drugs can exacerbate motor symptoms of PD. This studyinvestigated the current use and factors affecting prescription of gastrointestinal motility drugs in PD patients. Thisretrospective cohort study extracted 3 patient groups (high-risk anti-dopaminergic drugs, low-risk anti-dopaminergic drugsand trimebutine group), by using the National Health Insurance Service-National Sample Cohort database. The mostfrequently prescribed drug was domperidone (n=437). Age and Charlson comorbidity index (CCI) were significantlydifferent across three patient groups (p-value<0.05). Post hoc test (Tukey test) showed that high-risk group and trimebutinegroup were significantly different in age and CCI (p-value<0.05). The chi-square test for types of institution and clinicaldepartments were significantly different across patient groups (p-value<0.001). Compared to tertiary hospital, generalhospital [odds ratio (OR): 2.05, confidence interval (CI): 1.07-3.93], hospital/psychiatric hospital (OR: 4.28 CI: 2.11-8.65),and clinic (OR: 4.94 CI: 2.64-9.26) were more likely to prescribe high-risk drugs than low-risk drugs. Among clinicaldepartments, neurology (OR: 0.08 CI: 0.05-0.14) was less likely to prescribe high-risk drugs than low-risk drugs. Whencomparing low-risk drugs group and trimebutine group, low-risk drugs were less likely to be prescribed in general hospital(OR: 0.40 CI: 0.18-0.92), hospital/psychiatric hospital (OR: 0.24 CI: 0.10-0.58), and clinic (OR: 0.16 CI: 0.08-0.36) thanin tertiary hospital; Neurology (OR: 20.38 CI: 9.65-43.06) was more likely to prescribe low-risk drugs. Consequently,tertiary hospital and neurology were more likely to prescribe low-risk drugs than clinics and internal medicine, respectively.
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KEYWORD
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Parkison’s disease, nonmotor symptom, functional dyspepsia, gastrointestinal motility drugs, adverse event, metoclopramide, domperidone, levosulpiride
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FullTexts / Linksout information
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