파킨슨병 환자에서 위장관 운동조절제의 사용현황 및 처방에 미치는 요인

Current Status and Factors Affecting Prescription of Gastrointestinal Motility Drugs in Patients with Parkinson’s Disease

Gastrointestinal motility drugs have been prescribed to manage functional dyspepsia in Parkinson’s disease (PD). However, anti-dopaminergic gastrointestinal motility drugs can exacerbate motor symptoms of PD. This study investigated the current use and factors affecting prescription of gastrointestinal motility drugs in PD patients. This retrospective cohort study extracted 3 patient groups (high-risk anti-dopaminergic drugs, low-risk anti-dopaminergic drugs and trimebutine group), by using the National Health Insurance Service-National Sample Cohort database. The most frequently prescribed drug was domperidone (n=437). Age and Charlson comorbidity index (CCI) were significantly different across three patient groups (p-value<0.05). Post hoc test (Tukey test) showed that high-risk group and trimebutine group were significantly different in age and CCI (p-value<0.05). The chi-square test for types of institution and clinical departments were significantly different across patient groups (p-value<0.001). Compared to tertiary hospital, general hospital [odds ratio (OR): 2.05, confidence interval (CI): 1.07-3.93], hospital/psychiatric hospital (OR: 4.28 CI: 2.11-8.65), and clinic (OR: 4.94 CI: 2.64-9.26) were more likely to prescribe high-risk drugs than low-risk drugs. Among clinical departments, neurology (OR: 0.08 CI: 0.05-0.14) was less likely to prescribe high-risk drugs than low-risk drugs. When comparing low-risk drugs group and trimebutine group, low-risk drugs were less likely to be prescribed in general hospital (OR: 0.40 CI: 0.18-0.92), hospital/psychiatric hospital (OR: 0.24 CI: 0.10-0.58), and clinic (OR: 0.16 CI: 0.08-0.36) than in tertiary hospital; Neurology (OR: 20.38 CI: 9.65-43.06) was more likely to prescribe low-risk drugs. Consequently, tertiary hospital and neurology were more likely to prescribe low-risk drugs than clinics and internal medicine, respectively.