Since the discovery of levodopa (L-dopa) in 1967, the range of medications available to treat Parkinson’s disease has increased significantly and guidance on the use, efficacy, and safety of these medications has evolved. To assess levels of adherence to national prescribing guidelines and awareness of changes in the efficacy and safety data published in the profiles of medications for the treatment of PD, we have reviewed studies on patterns and determinants of prescribing PD medications conducted in the last 50 years (since the discovery of L-dopa). A systematic literature review was conducted using EMBASE (1967 to March, 2018), Ovid MEDLINE(R) ALL (1967 to March 16, 2018), PsycINFO (1967 to the 2^nd week of March, 2018), and PubMed to identify all studies measuring prescribing patterns of PD medication between 1967 and 2017. Study design, source of data, country, year of study, number of patients and/or prescriptions, unit of analysis, prescribing determinants, and percentage utilisation of PD medications were extracted where possible. 44 studies examining prescribing patterns and/or prescribing determinants across 17 countries were identified. Unsurprisingly, L-dopa was the most commonly prescribed medication in all studies, accounting for 46.50% to 100% of all prescriptions for PD. In several studies, the prescribing rate of ergot-derived dopamine agonists (DAs) decreased over time in concordance with guidance. In contrast, the prescribing rates of non-ergot DAs increased over the last ten years in most of the included studies. In examining prescribing factors, two major categories were exemplified, patients’ factors and prescribers’ factors, with patients’ age being the most common factor that affected the prescription in most studies. In conclusion, L-dopa is now the most commonly prescribed medication for cases of PD but there is large variation in the prescribing rates of catechol-O-methyltransferase (COMT) inhibitors, monoamine oxidase B (MAO-B) inhibitors, amantadine, and anticholinergics between countries. New studies examining the effects of recent clinical trials and measuring the prescribing rates of newly approved medications are warranted.

中文翻译：

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帕金森病处方的模式和决定因素：系统文献综述。


自 1967 年发现左旋多巴 (L-dopa) 以来，可用于治疗帕金森病的药物范围显着增加，并且对这些药物的使用、功效和安全性的指导也不断发展。为了评估对国家处方指南的遵守程度以及对帕金森病治疗药物概况中发布的疗效和安全性数据变化的认识，我们回顾了过去 50 年进行的关于帕金森病处方药物模式和决定因素的研究（自发现左旋多巴以来）。使用 EMBASE（1967 年至 2018 年 3 月）、Ovid MEDLINE(R) ALL（1967 年至 2018 年 3 月 16 日）、PsycINFO（1967 年至 2018 年 3 月^第2 周）和 PubMed 进行系统文献综述，以确定所有衡量 1967 年至 2017 年间 PD 药物处方模式的研究。尽可能提取研究设计、数据来源、国家、研究年份、患者和/或处方数量、分析单位、处方决定因素和 PD 药物使用百分比。确定了 44 项研究，检查 17 个国家的处方模式和/或处方决定因素。不出所料，左旋多巴是所有研究中最常用的处方药物，占所有 PD 处方药物的 46.50% 至 100%。在几项研究中，麦角衍生的多巴胺激动剂 (DA) 的处方率随着时间的推移而下降，与指导一致。相比之下，在大多数纳入的研究中，非麦角 DA 的处方率在过去十年中有所增加。在检查处方因素时，主要分为两大类：患者因素和处方者因素，在大多数研究中，患者年龄是影响处方的最常见因素。 总之，左旋多巴现在是治疗帕金森病最常用的药物，但儿茶酚-O-甲基转移酶 (COMT) 抑制剂、单胺氧化酶 B (MAO-B) 抑制剂、金刚烷胺和金刚烷胺的处方率存在很大差异。国家之间的抗胆碱能药物。有必要进行新的研究来检验最近的临床试验的效果并测量新批准药物的处方率。