Mitkova Z, Kamusheva M, Kalpachka D, Ignatova D, Tachkov K, Petrova G. Review of medicine utilization for Parkinson's disease management: the Bulgarian perspective.
J Public Health Res 2021;
10. [PMID:
34351100 PMCID:
PMC8744085 DOI:
10.4081/jphr.2021.2396]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Parkinson’s disease (PD), which occurs in 1% of the population, is the second most common neurodegenerative disorder. Despite the broad spectrum of PD manifestations and high disease prevalence, there are insufficient data on medicine utilization and prescription strategies. The purpose of the current study was to analyze published data concerning treatment approaches and to compare them with Bulgarian therapeutic practice.
Design and methods: We conducted a systematic review of the PubMed and Google Scholar databases, and we calculated medicine utilization in Bulgaria during 2018 and 2019 using the WHO methodology.
Results: The literature search identified a total of 311 publications, but only 12 met the inclusion criteria. Eleven studies pointed out that levodopa-containing medicine are the most frequently used, followed by dopamine agonists. The highest rate was found for levodopa-containing products and decarboxylase inhibitor (1.06 and 1.33 DDD/1000 inh/day), followed by anticholinergic Biperiden (0.494 and 0.455 DDD/1000 inh/day) during 2018 and 2019 in Bulgaria.
Conclusion: Overall, the treatment approaches used in the last decade comply with guideline recommendations, despite variations in levodopa and dopamine agonist utilization. Even though new medicines have been approved for PD management, levodopa- containing products are still most often prescribed and used worldwide.
Significance for public health
Parkinson’s disease is the second most common neurodegenerative disorder affecting high number of the population. The achieved clinical results and disease control depending on early patients’ diagnostic and treatment. This study emphasizes on medicines utilization and most often used treatment approaches on Parkinson’s disease management. In addition, this is the first study exploring medicines utilization in Bulgaria. The findings reveal real medicines utilization in Bulgaria during 2018-2019 and its comparison with those found in the other countries. Regardless development of new therapies, levodopa-containing products reveals the highest rate of utilization as in most of the compared countries as in Bulgaria
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