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A retrospective cohort study on the primary care service delivery to men and women diagnosed with Parkinson's disease and depression using the Canadian Primary Care Sentinel Surveillance Network

University of British Columbia

PURPOSE Parkinson’s disease is a complex neurodegenerative disease with depression as a common comorbidity known to negatively affect quality of life. Yet, limited evidence exists on how the two chronic conditions are treated simultaneously in Canadian primary care. This study aimed to describe the demographic and health characteristics of men and women with Parkinson’s disease and examine the differences in the number and type of medications for depression between men and women with Parkinson’s disease and depression. METHODS This retrospective cohort study analyzed available electronic medical records of patients with Parkinson’s disease who had at least one encounter with a primary care provider between September 30, 2012 and 2014 from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). In addition to descriptive statistics, Poisson and logistic regression were conducted to examine gender differences in depression treatments. An advisory group comprised of five primary care providers provided additional interpretation of the results. RESULTS A total of 1,815 patients (54.9% male) with Parkinson’s disease were found to be older, living in urban areas, overweight, non-smokers, and had an average of 15.5 encounters with a primary care provider over a two-year period. About 83.6% had at least one comorbidity with hypertension (64.1%) and depression (38.1%) as the most common. Of those who also had depression, 86.2% had at least one medication prescribed for depression; no significant difference was found in the number of medications prescribed by gender. The most frequently prescribed antidepressants were selective serotonin reuptake inhibitors (52.2%). CONCLUSIONS This study is unique in its reporting of antidepressant medication management for those with concurrent diagnoses of Parkinson’s disease and depression in primary care. It is the first pan-Canadian study to examine clinical electronic medical record data. The comorbidity of depression in those with Parkinson’s disease needs to be routinely assessed in primary care. Findings highlight the possible need for better decision-support tools consistent with Canadian guidelines to appropriately manage comorbid depression. While more population-level research is warranted, this study provided theoretical and practical knowledge for health care providers to holistically care and positively influence the quality of life of people with Parkinson’s disease.

Text

2015-10-24

Attribution-NonCommercial-NoDerivs 2.5 Canada

http://hdl.handle.net/2429/55009

Nursing

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/2.5/ca/