Differences in Parkinson's disease treatment between neurology and other departments in Japan

Background: Parkinson's disease is common in elderly people and is treated in the neurology department as well as in other departments. Recently, treatment options for Parkinson's disease have expanded; this complicates selection of the best treatment regimen.Aim: To investigate the change in Parkinson's disease treatment in Japan and assess the differences in prescriptions between neurology and other departments.Methods: Patients with Parkinson's disease who were prescribed levodopa and/or non-ergot dopamine agonist were analyzed in an observational study using a Japanese claims database (April 2008-July 2017). The percentage of patients receiving each antiparkinsonian drug and the proportion of patients prescribed levodopa alone, levodopa plus non-ergot dopamine agonist, and non-ergot dopamine agonist alone were calculated by year (2010-2017) and department (neurology or other departments).Results: We identified 50,408 patients (mean [standard deviation] age: 73.4 [10.3]), including 25,231 (71.3 [10.1]) and 25,177 (75.5 [10.2]) patients who received their initial Parkinson's disease treatment in neurology and other departments, respectively. The popularity of levodopa alone and levodopa plus non-ergot- dopamine agonist varied in the neurology department, while levodopa alone was the most popular treatment choice in all investigated years in other departments.Conclusions: The number of patients initially treated for Parkinson's disease in neurology department, relative to other departments, did not differ. The treatment changes were observed in the neurology department but not in other departments.