Objective

To examine the national prevalence of pharmacological treatment of affective disorders in older adults with Parkinson's disease (PD), and determine the prevalence and risk factors for receipt of an American Geriatrics Society Beers Criteria® defined potentially inappropriate medication (PIM) for affective disorder treatment.

Design

Cross-sectional analysis of 2014 Medicare data.

Setting

Research Identifiable File data from the Centers for Medicare and Medicaid Services.

Participants

Individuals ≥65 years of age with PD whose inpatient, outpatient, and prescription care is administered through the U.S. Medicare Program.

Measurements

The 2014 prevalence of affective (i.e., depressive and anxiety) disorders was calculated. We assessed prescription fills for affective disorder treatment and classified prescriptions according to PIM status. Patient and clinician factors associated with PIM prescriptions were determined.

Results

Of 84,323 beneficiaries with PD, 15.1% had prevalent depression only, 7.5% had anxiety only, and 8.5% had comorbid depression and anxiety. Among those with depression only, 80.7% were treated in 2014 (12.8% of treated received at least one PIM). The annual treatment prevalence was 62.9% (75.9% PIM) and 93.1% (63.9% PIM) in the anxiety only and comorbid group, respectively. In most groups, PIM use was less likely among men and those with dementia; geriatricians were less likely to prescribe PIMs.

Conclusion

Treatment of affective disorders in persons diagnosed with PD is high. PIM use is also common, particularly in persons with anxiety. Future research will quantify the potential effects of these PIMs on clinical and patient outcomes.

中文翻译：

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使用潜在不适当药物治疗帕金森病情感障碍的年度流行率。

客观的

旨在检查帕金森病 (PD) 老年人情感障碍药物治疗的全国流行率，并确定接受美国老年医学会 Beers Criteria® 定义的用于情感障碍治疗的潜在不适当药物 (PIM) 的流行率和风险因素。

设计

2014 年医疗保险数据的横断面分析。

环境

研究来自医疗保险和医疗补助服务中心的可识别文件数据。

参与者

≥ 65 岁的 PD 患者，其住院、门诊和处方护理均通过美国医疗保险计划进行。

测量

计算了 2014 年情感（即抑郁和焦虑）障碍的患病率。我们评估了情感障碍治疗的处方量，并根据 PIM 状态对处方进行了分类。确定了与 PIM 处方相关的患者和临床医生因素。

结果

在 84,323 名 PD 受益人中，15.1% 仅患有抑郁症，7.5% 仅患有焦虑症，8.5% 患有抑郁症和焦虑症。在仅患有抑郁症的患者中，80.7% 的患者在 2014 年接受了治疗（12.8% 的患者接受了至少一种 PIM）。仅焦虑组和共病组的年治疗流行率分别为 62.9% (75.9% PIM) 和 93.1% (63.9% PIM)。在大多数群体中，男性和痴呆症患者使用 PIM 的可能性较小；老年科医生不太可能开 PIM。

结论

被诊断患有 PD 的人的情感障碍治疗率很高。PIM 的使用也很常见，尤其是在焦虑症患者中。未来的研究将量化这些 PIM 对临床和患者结果的潜在影响。