PND59 - Drug Compliance and Persistence in Patients with Parkinson’s Disease Treated in Primary Care in the United Kingdom: A CPRD-Based Study

Abstract

Differences in compliance and persistence between Parkinson’s disease (PD) drugs were found in a previous US claim database analysis. The objective was to apply the same methodology in another setting using the Clinical Practice Research Datalink (CPRD) in the UK. A retrospective analysis of patients starting a new PD drug (rasagiline, selegiline, pramipexole, ropinirole, entacapone, tolcapone, levodopa) between January 2009 and January 2012 was conducted using CPRD. Patients were categorized as naive to PD therapy (NT) or having prior PD therapy (PT), depending on the prescription of other PD drugs within a 12-month look-back period. The observation period was 12 months. Compliance was measured using the medication possession ratio (MPR) and non-compliance was defined as an MPR≤80%. Persistence was measured as the duration (days) of uninterrupted therapy without gap higher than 45 days. Of the 4,784 patients included in the compliance analysis, 3,675 patients (76.8%) had compliance rates >80%. Mean MPRs were generally comparable across PD products (range:84%-90%, all pairwise p=NS). Percentage of patients with MPR>80% was significantly greater with rasagiline (85.6%, all p<0.05 except vs. ropinirole p=NS). Of the 5,266 patients included in the persistence analysis, the highest mean number of persistent days of treatment was reported for rasagiline (284 days; all p<0.05 vs others, except vs. ropinirole p=0.14 and levodopa p=0.06). Patient persistence at 12 months was significantly greater with rasagiline compared with others in NT patients (66.5%, all p<0.05) and with levodopa in PT patients (72.7%, all p<0.05). A high and comparable level of compliance was observed across PD drugs. Persistence was significantly higher than other drugs with rasagiline in treatment-naïve patients and with levodopa in previously treated patients.