TITLE:
Medication Side Effect Profiles in PD Patients in a Safety-Net Hospital
AUTHORS:
Daniella C. Sisniega, Divya Madhusudhan, Elham Rahmani, Robert McInnis, Janice Weinberg, Marie-Hélène Saint-Hilaire, Anna DePold Hohler
KEYWORDS:
Parkinson’s Disease, Medication Side Effects, Safety-Net Hospital
JOURNAL NAME:
Advances in Parkinson's Disease,
Vol.6 No.4,
September
19,
2017
ABSTRACT: Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations
are common Parkinson’s disease (PD) medication side effects.
These are yet to be examined in relation to race and level of education. The
goal of this analysis was to identify socioeconomic or clinical variables that are
associated with compulsive behavior, dyskinesias, motor fluctuations, and
hallucinations in patients in a safety-net hospital. Methods: A movement disorder
patient database containing 452 patients with idiopathic PD was analyzed
for differences in PD medication side effects using univariate and multivariate
logistic regression analysis. Race, sex, and level of education were
evaluated as possible confounders. Results: A greater proportion of the patients
in this study were Caucasian males. The only variable associated with
compulsive behavior was age, with higher age having a protective effect (p =
0.0336). Disease duration (defined as time since the onset of symptoms), diagnosis
duration (time since formal diagnosis), and level of education were
significantly associated with dyskinesia inunivariate analysis (p =p =
0.0038), in addition to a borderline significant association when comparing
individuals with graduate degree to those who had completed high school
education or less (p = 0.0599), with a protective effect of higher education.
Disease duration, diagnosis duration, and use of monoamineoxidase inhibitors
were also significantly associated with motor fluctuations in the univariate
analysis, while only diagnosis duration was significantly associated with motor
fluctuations in multivariate analysis (p = 0.0035) with longer diagnosis duration
associated with higher risk of motor fluctuations. Age, disease duration,
and diagnosis duration were associated with an increased risk of hallucinations in univariate analysis (p =p = 0.0009, 0.1196 respectively). Race was not associated
with a higher risk of compulsive behavior, dyskinesias, motor fluctuations, or
hallucinations. Conclusion: Compulsive behavior, dyskinesias, motor fluctuations,
and hallucinations in our PD population may be associated with differences
in socioeconomic status and access to care, but not with differences in
race.