Objective. The aim of this study is to compare Parkinson’s disease (PD) treatment practices by movement disorder (MD) specialists across a decade, and to determine the factors that influence drug choice for the motor symptoms of PD in newly diagnosed drug-naïve patients. Methods. This prospective temporal analysis included patients seen at the National Neuroscience Institute in Singapore and diagnosed with PD by MD specialists in the years 2007 and 2017. Primary outcomes were use of specific PD drugs and changes in drug-prescribing patterns. Descriptive analyses and multivariable logistic regression models determined the extent to which patient characteristics were associated with type of PD treatment. Results. Of 230 patients with PD (mean (SD) age, 66.7 (10.3) years), 131 (57.0%) were male. From 2007 to 2017, the use of ergot dopamine agonists and anticholinergics decreased from 19.3% to 2.0% () and from 12.0% to 2.7% (), respectively. The use of monoamine oxidase B inhibitors (MAOBI) increased from 13.3% to 25.2% (). The use of levodopa (LD)-sparing strategies decreased nonsignificantly from 33.7% to 24.5% (). Overall, 196 (85.2%) patients were initiated on symptomatic monotherapy, with LD being the most commonly prescribed. MAOBI was the most common drug used in combination therapy. Age ≤70 (adjusted OR, 11.9; 95% CI, 4.5–31.5) and Hoehn and Yahr (HY) stage <2 (adjusted OR, 3.4; 95% CI, 1.5–7.7) were independent factors for LD-sparing strategies. Non-LD prescriptions (13 of 92; 14.1%) were more likely to be discontinued compared to LD ones (6 of 149; 4.0%) (). Conclusions. Drug-prescribing patterns in PD have changed significantly through the last decade, influenced by emerging evidence and reports of adverse drug effects. Choosing drugs based on the patient’s age and disease severity remain sound guiding principles across the years. It is important that international and national guidelines for pharmacotherapy in PD be updated consistently throughout different socioeconomic settings to optimize care.

中文翻译：

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新加坡十年来新诊断帕金森病患者初始药物治疗的演变。

客观。本研究的目的是比较运动障碍 (MD) 专家在十年间的帕金森病 (PD) 治疗实践，并确定影响新诊断的未接受药物治疗患者 PD 运动症状药物选择的因素。方法。这项前瞻性时间分析包括 2007 年和 2017 年在新加坡国家神经科学研究所就诊并由 MD 专家诊断为 PD 的患者。主要结果是特定 PD 药物的使用和药物处方模式的变化。描述性分析和多变量逻辑回归模型确定了患者特征与 PD 治疗类型相关的程度。结果. 在 230 名 PD 患者中（平均 (SD) 年龄，66.7 (10.3) 岁），131 名 (57.0%) 为男性。从 2007 年到 2017 年，麦角多巴胺激动剂和抗胆碱能药的使用率分别从 19.3% 下降到 2.0% ( )和从 12.0% 下降到 2.7% ( )。单胺氧化酶 B 抑制剂 (MAOBI) 的使用率从 13.3% 增加到 25.2% ( )。左旋多巴 (LD) 保留策略的使用率从 33.7% 无显着下降至 24.5% ( )。总体而言，196 名 (85.2%) 患者开始对症单药治疗，其中 LD 是最常用的处方。MAOBI 是联合治疗中最常用的药物。年龄≤70（调整后的 OR，11.9；95% CI，4.5-31.5）和 Hoehn 和 Yahr (HY) 阶段 <2（调整后的 OR，3.4；95% CI，1.5-7.7）是 LD 保留策略的独立因素。非 LD 处方（92 个中的 13 个；14.1%）与 LD 处方（149 个中的 6 个；4.0%）相比更有可能被停用（）。结论 . 在过去十年中，受新出现的证据和药物不良反应报告的影响，PD 的药物处方模式发生了显着变化。多年来，根据患者的年龄和疾病严重程度选择药物仍然是合理的指导原则。重要的是，在不同的社会经济环境中不断更新国际和国家 PD 药物治疗指南，以优化护理。