Impact of recommendations on the initial therapy of Parkinson's disease: a population-based study in France.

Claudine Fayard 1 Audrey Bonaventure 2 Isabelle Benatru 1 Emmanuel Roze 3 Julien Dumurgier 2, 4 Frédéric Moisan 2 Aïcha Soumaré 2 Jean Houssinot 5 Jean-Luc Dupupet 5 Jean-Louis Mazurie 6 Irina Balaboi 7 Jean-Luc Houeto 7 Elsa Krim 8 Danièle Ranoux 9 Marcel Goldberg 10 Ellen Imbernon 11 Thibault Moreau 1 Maurice Giroud 1 Christophe Tzourio 2 Alexis Elbaz 2, 11, *
* Auteur correspondant
1 Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon)
2 Neuroépidémiologie
3 Fédération des Maladies du Système Nerveux
4 CMRR - Centres Mémoire de Ressource et de Recherche Paris Nord -IDF
5 Caisse centrale
6 Caisse départementale de la Gironde
7 Service de neurologie [Poitiers]
8 Service de neurologie
9 Service de Neurologie [CHU Limoges]
10 CESP - Centre de recherche en épidémiologie et santé des populations
11 DST-InVS - Département santé travail
Abstract : Levodopa induces long-term motor complications in Parkinson's disease (PD). Therapeutic strategies that prevent motor complications are needed. Our aim was to evaluate the impact of recommendations of a French consensus conference published in 2000 on initial PD therapy. We identified 308 PD patients as part of a population-based study performed within the Mutualité Sociale Agricole in five French districts (2007). Neurologists confirmed PD diagnosis. We compared initial therapy in 102 patients treated before 12/31/2000 to that of 206 patients treated afterwards. Initial treatment was in agreement with the recommendations if dopamine agonists were used in patients <60 years (n = 49) and levodopa in patients ≥70 years (n = 133). Agreement with the recommendations increased after 2000 (66.0%) compared to before (46.3%, p = 0.025). For patients <60 years, agreement increased (64.0% vs 20.2%, p = 0.017) while it remained stable (66.4% vs 70.6%, p = 0.73) in patients ≥70 years. The publication of recommendations has influenced initial treatment choices for PD in France.
keyword : Parkinson's disease Guidelines Epidemiology Medical practice
Type de document :
Article dans une revue
Parkinsonism and Related Disorders, Elsevier, 2011, 17 (7), pp.543-6. 〈10.1016/j.parkreldis.2011.04.020〉
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Claudine Fayard, Audrey Bonaventure, Isabelle Benatru, Emmanuel Roze, Julien Dumurgier, et al.. Impact of recommendations on the initial therapy of Parkinson's disease: a population-based study in France.. Parkinsonism and Related Disorders, Elsevier, 2011, 17 (7), pp.543-6. 〈10.1016/j.parkreldis.2011.04.020〉. 〈inserm-00598387〉

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