The Impact of Non-dopaminergic Medication on Quality of Life in Parkinson’s Disease

• Published in: Clinical drug investigation 2021-09, Vol.41 (9), p.809-816
• Main Authors: Oonk, Nicol G. M., Movig, Kris L. L., van der Palen, Job, Nijmeijer, Henk-Willem, van Kesteren, Mirjam E., Dorresteijn, Lucille D. A.
• Format: Article
• Language: English
• Subjects: Comorbidity; Contraindications; Internal Medicine; Medicine; Medicine & Public Health; Original Research Article; Parkinson's disease; Patients; Pharmacists; Pharmacology/Toxicology; Pharmacotherapy; Polypharmacy; Prescription drugs; Quality of life; Questionnaires; Regression analysis
• ISSN: 1173-2563; 1179-1918
• DOI: 10.1007/s40261-021-01064-z

Background and Objectives Quality of life (QoL) in Parkinson’s disease (PD) depends on multiple factors. Due to PD treatment and accompanying, age-related or independent comorbidities, pill burden is often high. The relation of QoL and pharmacotherapy for comorbidities in PD has not been widely studied. This study investigated if and to what extent non-dopaminergic drugs are related to QoL in PD. Second, the impact of demographics and non-motor symptoms were evaluated. A better understanding of the impact of different non-dopaminergic drugs and polypharmacy on QoL will have added value in selecting appropriate (medication) interventions. Methods In a cross-sectional analysis, medication prescription data of 209 PD patients were analyzed and grouped according to the Rx-Risk comorbidity index. QoL was measured using the PDQ-39 questionnaire. Non-motor symptoms were analyzed with the Non-Motor Symptoms questionnaire. Independent factors associated with a reduced QoL were identified with a multivariate linear regression analysis. Results Non-dopaminergic drugs, subdivided into Rx-Risk comorbidity categories, were not associated with reduced QoL, except for the use of anti-epileptic drugs. However, using more daily non-dopaminergic drugs was also negatively associated with QoL, as well as female sex, increased PD severity, and more non-motor symptoms. Contraindicated non-dopaminergic medication was barely prescribed (0.4%). Conclusion Non-dopaminergic drugs are frequently prescribed, and higher numbers are associated with impaired QoL in PD. However, when divided in drug types, only anti-epileptic drugs were negatively associated with QoL. In these patients, physicians might improve QoL by further optimizing the condition it was prescribed for (e.g., pain or anxiety), or managing of side effects. Trial registration Netherlands Trial Register; NL4360.