{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:12:25Z","timestamp":1774519945630,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Guidelines highlight the importance of an individualized approach to treatment initiation for Parkinson\u2019s disease. Our aim was to investigate initiation of anti-Parkinson medication in Australia from 2013\u20132018, and to determine factors predicting choice of initial treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Cohort of new-users (<jats:italic>N<\/jats:italic>\u2009=\u20094,887) of anti-Parkinson medication aged\u2009\u2265\u200940\u00a0years were identified from a 10% random representative sample of national medication dispensing data from July-2013 to June-2018. Changes in treatment initiation were examined across the whole cohort and stratified by age and sex.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Treatment initiation was most frequent with levodopa followed by non-ergot dopamine agonists (DAs) and anticholinergics. Two thirds initiated with levodopa across the study period. Initiation with non-ergot DAs increased from 22 to 27% (rate ratio, RR 1.23, 95% confidence interval, CI 1.02\u20131.47) and initiation with anticholinergics decreased from 6.9% to 2.4% (RR 0.34, 95% CI 0.21\u20130.55) from 2013\u20132018. Among persons aged\u2009\u2265\u200965\u00a0years, one third of women and one fourth of men initiated on levodopa. Among women aged\u2009&lt;\u200965\u00a0years, rates of treatment initiation with DAs (37%) and levodopa (37%) were similar in 2013\/2014 but initiation with DA exceeded levodopa thereafter. Among men aged\u2009&lt;\u200965\u00a0years, treatment initiation with levodopa (44%-49%) remained more frequent than initiation with DAs (29%-32%) throughout the study period.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Treatment initiation with levodopa was most frequent among persons aged\u2009\u2265\u200965\u00a0years, consistent with current guidelines. Whilst the value of levodopa sparing strategies is unclear, treatment initiation with DA has become increasingly common relative to levodopa among women but not among men aged\u2009&lt;\u200965\u00a0years.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12877-022-03095-3","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T20:03:23Z","timestamp":1654286603000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Treatment initiation for parkinson\u2019s disease in Australia 2013\u20132018: a nation-wide study"],"prefix":"10.1186","volume":"22","author":[{"given":"Marjaana","family":"Koponen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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The authors analysed non-identifiable data provided by Services Australia. No participants were contacted and informed consent was not required. The study was approved by the Monash University Human Research Ethics Committee (approval number 22877). The analysis plan was approved and the manuscript noted by the External Request Evaluation Committee chaired by Services Australia.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics and analysis approval and consent to participate"}},{"value":"Not applicable","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JSB and JI have received funding from Dementia Australia and Yulgilbar Foundation. JSB is funded by a National Health and Medical Research Council Boosting Dementia Leadership Fellowship and has received grant funding from National Health and Medical Research Council (NHMRC), Victorian Government Department of Health and Human Services (DHHS) and Dementia Australia Research Foundation (DARF), GlaxoSmithKline and several aged care provider organizations unrelated to this work. RW is supported by the Yulgilbar Alzheimer\u2019s Research Program. AMK has received grant funding from HS Pitk\u00e4nen Foundation and P\u00e4ivikki and Sakari Sohlberg Foundation unrelated to this work. AMK has also received payments for lectures given to medical professionals from TEVA, Allergan, Nutricia, and Finnish Medical Society Duodecim and travel grants for medical congresses from the Finnish Neurological Association, TEVA, Roche, Allergan, and Biogen. JI has received grant funding from the NHMRC, Victorian Government DHHS, National Breast Cancer Foundation and DARF and consultancies from AstraZeneca unrelated to this work. SL and MK have nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"483"}}