Table 2.
The impact of PD guidelines reference on the selection of medication under specific circumstances
| Items | Overall (n = 717) | Haven’t read the PD guidelines (n = 57) | Have read the PD guidelines (n = 660) | χ2 | P value |
|---|---|---|---|---|---|
| Age < 65 years without cognitive impairment | |||||
| Levodopa | 185 (25.8%) | 5 (8.8%) | 180 (27.3%) | 9.3807 | 0.0022 |
| Dopamine agonists | 334 (46.6%) | 4 (7.0%) | 330 (50.0%) | 38.9561 | < 0.0001 |
| MAO-B inhibitors | 164 (22.9%) | 2 (3.5%) | 162 (24.6%) | 13.1620 | 0.0003 |
| Benzhexol | 49 (6.8%) | 0 (0.0%) | 49 (7.4%) | 4.5422 | 0.0331 |
| Amantadine | 101 (14.1%) | 1 (1.8%) | 100 (15.2%) | 7.7814 | 0.0053 |
| Levodopa + COMT inhibitors | 95 (13.3%) | 1 (1.8%) | 94 (14.2%) | 7.1189 | 0.0076 |
| Age > 65 years without cognitive impairment | |||||
| Levodopa | 345 (48.1%) | 7 (12.3%) | 338 (51.2%) | 31.8549 | < 0.0001 |
| Dopamine agonists | 181 (25.2%) | 3 (5.3%) | 178 (27.0%) | 13.1001 | 0.0003 |
| MAO-B inhibitors | 101 (14.1%) | 3 (5.3%) | 98 (14.9%) | 3.9834 | 0.0460 |
| Benzhexol | 32 (4.5%) | 0 (0.0%) | 32 (4.9%) | 2.8927 | 0.0890 |
| Amantadine | 69 (9.6%) | 2 (3.5%) | 67 (10.2%) | 2.6620 | 0.1028 |
| Levodopa + COMT inhibitors | 145 (20.2%) | 1 (1.8%) | 144 (21.8%) | 13.0918 | 0.0003 |
| Wearing off phenomenon | |||||
| Add levodopa dose | 127 (17.7%) | 3 (5.3%) | 124 (18.8%) | 6.5847 | 0.0103 |
| Adjust protein diet | 182 (25.4%) | 2 (3.5%) | 180 (27.3%) | 15.6441 | < 0.0001 |
| Switch from standard levodopa to CR levodopa | 261 (26.4%) | 3 (5.3%) | 258 (39.1%) | 25.9346 | < 0.0001 |
| Add COMT inhibitors or MAO-B inhibitors | 327 (45.6%) | 5 (8.8%) | 322 (28.8%) | 33.8682 | < 0.0001 |
| Recommend surgical treatment | 83 (11.6%) | 0 (0.0%) | 83 (12.6%) | 8.1066 | 0.0044 |
| Peak-dose dyskinesia | |||||
| Reduce levodopa dose, add its frequency | 297 (41.4%) | 5 (8.8%) | 292 (44.2%) | 27.2061 | < 0.0001 |
| Reduce levodopa dose, add dopamine agonists | 319 (44.5%) | 7 (12.3%) | 312 (47.3%) | 26.0137 | < 0.0001 |
| Reduce levodopa dose, add COMT inhibitors | 251 (35.0%) | 5 (8.8%) | 246 (37.3%) | 18.7324 | < 0.0001 |
| Reduce levodopa dose, add MAO-B inhibitors | 206 (28.7%) | 4 (7.0%) | 202 (30.6%) | 14.2578 | 0.0002 |
| Add amantadine | 182 (25.4%) | 2 (3.5%) | 180 (27.3%) | 15.6441 | < 0.0001 |
| Switch from CR levodopa to standard levodopa | 110 (15.3%) | 0 (0.0%) | 110 (16.7%) | 11.2216 | 0.0008 |
| PD with psychosis (advanced stage) | |||||
| Reduce levodopa dose | 147 (20.5%) | 2 (3.5%) | 145 (22.0%) | 10.9712 | 0.0009 |
| Add antipsychotics | 321 (44.8%) | 11 (19.3%) | 310 (47.0%) | 16.2481 | < 0.0001 |
| PD with visual hallucination and delirium during treatment (ineffective with drug adjustment) | |||||
| Clozapine | 267 (37.2%) | 13 (22.8%) | 254 (38.5%) | 5.5181 | 0.0188 |
| Olanzapine | 301 (42.0%) | 22 (38.6%) | 279 (42.3%) | 0.2911 | 0.5895 |
| Quetiapine | 301 (42.0%) | 9 (15.8%) | 292 (44.2%) | 17.4394 | < 0.0001 |
| Risperidone | 85 (11.9%) | 3 (5.3%) | 82 (12.4%) | 2.5749 | 0.1086 |
| PD with depression | |||||
| Tricyclic antidepressants | 59 (8.2%) | 8 (14.0%) | 51 (7.7%) | 2.7645 | 0.0964 |
| SSRIs, e.g. sertraline | 487 (67.9%) | 39 (68.4%) | 448 (67.9%) | 0.0071 | 0.9329 |
| Pramipexole | 420 (58.6%) | 20 (35.1%) | 400 (60.6%) | 14.0811 | 0.0002 |
| PD with dementia (PDD) | |||||
| Huperzine A | 82 (11.4%) | 1 (1.8%) | 81 (12.3%) | 5.7312 | 0.0167 |
| Donepezil | 346 (48.3%) | 13 (22.8%) | 333 (50.5%) | 16.0620 | < 0.0001 |
| Rivastigmine tartrate | 275 (38.4%) | 7 (12.3%) | 268 (40.6%) | 17.8047 | < 0.0001 |
| Memantine | 397 (55.4%) | 15 (26.3%) | 382 (57.9%) | 21.1521 | < 0.0001 |
| Traditional Chinese Medicine (TCM), e.g. ginkgo leaf | 82 (11.4%) | 1 (1.8%) | 81 (12.3%) | 5.7312 | 0.0167 |
| PD with periodical limb movement syndrome (PLMS) or restless legs syndrome (RLS) | |||||
| Levodopa | 153 (21.3%) | 6 (10.5%) | 147 (22.3%) | 4.3130 | 0.0378 |
| Dopamine agonists | 376 (52.4%) | 6 (10.5%) | 370 (56.1%) | 43.6187 | < 0.0001 |
| Amantadine | 17 (2.4%) | 0 (0.0%) | 17 (2.6%) | 1.5038 | 0.2201 |
| Benzodiazepines | 94 (13.1%) | 3 (5.3%) | 91 (13.8%) | 3.3472 | 0.0673 |