Yonsei Med J.  2019 Aug;60(8):760-767. 10.3349/ymj.2019.60.8.760.

Trends in the Prevalence of Drug-Induced Parkinsonism in Korea

Affiliations
  • 1Pharmaceutical Policy Research Team, Health Insurance Review and Assessment Service, Wonju, Korea.
  • 2College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea. smjang@gachon.ac.kr
  • 3Department of Neurology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea. hima@hallym.ac.kr
  • 4Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 5Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Discontinuation of offending drugs can prevent drug-induced parkinsonism (DIP) before it occurs and reverse or cure it afterwards. The aim of this study was to investigate the prevalence of DIP and the utilization of offending drugs through an analysis of representative nationwide claims data.
MATERIALS AND METHODS
We selected DIP patients of ages ranging from 40 to 100 years old with the G21.1 code from the Korean National Service Health Insurance Claims database from 2009 to 2015. The annual standardized prevalence of DIP was explored from 2009 to 2015. Trends were estimated using the compound annual growth rate (CAGR) and the Cochran-Armitage test for DIP over the course of 6 years. Additionally, the utilization of offending drugs was analyzed.
RESULTS
The annual prevalence of DIP was 4.09 per 100000 people in 2009 and 7.02 in 2015 (CAGR: 9.42%, p<0.001). Levosulpiride use before and after DIP diagnosis showed a clear trend for decreasing utilization (CAGR: −5.4%, −4.3% respectively), whereas the CAGR for itopride and metoclopramide increased by 12.7% and 6.4%, respectively. In 2015, approximately 46.6% (858/1840 persons) of DIP patients were prescribed offending drugs after DIP diagnosis. The most commonly prescribed causative drug after DIP diagnosis was levosulpiride.
CONCLUSION
The prevalence of DIP has increased. To prevent or decrease DIP, we suggest that physicians reduce prescriptions of benzamide derivatives that have been most commonly used, and that attempts be made to find other alternative drugs. Additionally, the need for continuing education about offending drugs should be emphasized.

Keyword

Drug-induced parkinsonism; Parkinson disease; offending drugs; antiemetic and gastric mobility agents; levosulpiride

MeSH Terms

Diagnosis
Education, Continuing
Humans
Insurance, Health
Korea*
Metoclopramide
Parkinson Disease
Parkinsonian Disorders*
Prescriptions
Prevalence*
Metoclopramide
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