CPCSSN assists in study of prescribed medication

A Parkinson’s disease diagnosis can be a devastating blow to any patient; however, never before has Canadian patient data been analysed to determine the treatment patterns for a concurrent diagnosis of depression.

UBC graduate Kimberly Singian, RN, MSN, with co-authors, Dr. Morgan Price, Dr. Victoria Bungay, and Dr. Sabrina Wong, analysed the associations between Parkinson’s disease, depression, and related medications. The study was made possible with the use of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), which extracts data from a variety of electronic medical records (EMRs) in use across Canada, with input from more than a thousand family physicians and nurse practitioners, and creates a repository of clinical EMR data from over a million patients. It is then possible to pull together data from patients across Canada who have similar diagnoses. Thanks to CPCSSN, Singian’s study, Using Canadian Primary Care Sentinel Surveillance Network data to examine depression in patients with a diagnosis of Parkinson disease: a retrospective cohort study is the first in Canada to look at the pharmacologic management of depression in patients who have Parkinson’s disease in primary care. “Parkinson’s disease is not just a motor disease,” says Singian. “It is also accompanied by non-motor features that can negatively affect quality of life,” including depression.

It is no wonder, then, that current evidence shows depression occurring in up to half of cases and in this study, almost 40% of Parkinson’s patients have a concurrent diagnosis of depression. The study further reveals that depression in these patients is treated primarily with selective serotonin reuptake inhibitors (SSRIs) type antidepressants, such as Zoloft, Paxil, or Prozac.

Singian’s research team found that Canadian Parkinson’s guidelines for depression management may need to be revisited because the guidelines suggest that the first line of treatment for depression in those with Parkinson’s is amytryptiline, whereas in practice, the prescribing of SSRIs is predominant. This study also indicates that more evidence and decision-support tools should be offered to examine the efficacy of antidepressants and to assist clinicians in evaluating the frequent SSRI prescriptions in this patient population.

Comparing real-time prescribing data in Canada with the most up-to-date healthcare knowledge is key to ensuring the best in patient care.

To read the study in the Canadian Medical Association Journal, visit http://cmajopen.ca/content/4/3/E417.long