Journal
AGE AND AGEING
Volume 49, Issue 5, Pages 786-792Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ageing/afaa033
Keywords
Parkinson's disease; potentially inappropriate medication list; inappropriate prescribing; Beers Criteria; older people
Categories
Funding
- National Institute ofNeurological Diseases and Stroke of the National Institutes of Health [R01 NS099129]
- National Institutes of Health [R01 NS099129, R01 AG025152, R01 AG060975, R01 AG056326, U01 AG006781]
- Parkinson's Foundation
- Michael J. Fox Foundation for Parkinson's Research
- Alzheimer's Therapeutic Research Initiative (ATRI)
- Alzheimer's Disease Cooperative Study (ADCS)
- International Parkinson and Movement Disorder Society (IPMDS)
- Centers for Disease Control and Prevention [U01CE002967]
- University of Pennsylvania
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Background: impairments in neurotransmitter pathways put Parkinson's disease (PD) patients at risk for drug-disease interactions and adverse medication events. Objective: to determine the prevalence and risk factors for potentially inappropriate medication (PIM) prescriptions, as defined by the 2015 Beers List, in PD. Methods: cross-sectional analysis was conducted on 2014 Medicare beneficiaries with PD who had parts A, B and D coverage. The prevalence of PIM prescriptions for older adults was determined overall, and specifically for medications that can exacerbate motor symptoms or cognitive impairment in PD. Logistic regression models were constructed to determine the association between age, sex, race, geography and poverty with PIM prescriptions. Results: the final sample included 458,086 beneficiaries. In 2014, 35.8% of beneficiaries with PD filled a prescription for at least one PIM for older adults. In total, 8.7% of beneficiaries received a PIM that could exacerbate motor symptoms and 29.0% received a PIM that could worsen cognitive impairment. After adjustment, in all models, beneficiaries who were younger, female, white, urban-dwelling and eligible for Medicaid benefits were more likely to receive a PIM. Conclusion: PIM prescriptions are not uncommon in PD, particularly for medications that can exacerbate cognitive impairment. Future research will examine underlying drivers of sex and other disparities in PIM prescribing. Additional studies are needed to understand the impact of PIMs on disease symptoms, healthcare utilisation and patient outcomes.
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