Abstract Details

Title Prescribing Patterns for Patients With Parkinson’s Disease in Long-Term Care Facilities

Topic Movement Disorders

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-002

Objective Describe the use of maintenance oral carbidopa/levodopa (CD/LD), adjunctive treatment (“ON-extenders”), and “on-demand” treatment in patients with Parkinson’s disease (PD) that reside in long-term care (LTC) facilities.

Background

CD/LD reduces motor symptoms in patients with PD. Changes to CD/LD or addition of “ON-extenders” and “on-demand” treatment can manage worsening symptoms. Patients with PD may be admitted to LTC facilities; treatment data in this setting are scarce.

Design/Methods

A retrospective longitudinal analysis was performed using PharMerica pharmacy claims data (01/01/2013–12/31/2019). Unique patient-level stay was the unit of analysis. Inclusion criteria were stays with PD drug-related pharmacy record and resident record, CD/LD or CD/LD/entacapone prescription, and >30-day observed length of stay (LOS). Stays were observed from the later of admission date and 01/01/2013 through the earlier of discharge date and 12/31/2019. Use of PD therapies and treatment changes after initial CD/LD were characterized. Time to change was described via Kaplan-Meier survival analysis.

Results Overall, 56,404 stays met the inclusion criteria. Mean LOS was 507 days. Among all PD-related drug records (N=873,038), the most common drug classes included dopamine precursors (80.5%), catechol-O-methyltransferase inhibitors (6.0%), anticholinergics (4.4%), monoamine oxidase-B inhibitors (3.8%), and N-methyl-D-aspartate receptor antagonists (3.8%). The mean number of PD-related drugs/drug classes per stay were 1.3 and 1.2, respectively. After initial CD/LD prescription, dose/formulation change and “ON-extender” initiation occurred in 13.9% and 10.8% of stays, respectively; “on-demand” treatment occurred in 1 stay. Mean times from initial CD/LD prescription to dose/formulation change, “ON-extender” initiation, or “on-demand” treatment were 6.0, 3.2, and 34.8 months, respectively.

Conclusions

The use of PD-related drugs in the LTC setting was modest. Although some evidence of dose or formulation changes and initiation of “ON-extenders” suggests efforts towards optimizing the treatment regimens of LTC residents with PD, the near-zero use of “on-demand” treatment suggests that this approach to managing PD may be underutilized.

Authors/Disclosures
Andrew Thach, PhD (Sunovion Pharmaceuticals Inc.) PRESENTER	Dr. Thach has received personal compensation for serving as an employee of Sunovion Pharmaceuticals Inc.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Darshan Mehta	Darshan Mehta has received personal compensation for serving as an employee of Sunovion Pharmaceuticals Inc. .

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