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Clinical Practice Regarding Dopamine-Agonist Use and Driving in Parkinson's Disease

Published online by Cambridge University Press:  02 December 2014

R. M.A. de Bie
Affiliation:
Movement Disorders Centre, Division of Neurology, University of Toronto, Toronto, Ontario, Canada Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
J. Miyasaki
Affiliation:
Movement Disorders Centre, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
A. E. Lang
Affiliation:
Movement Disorders Centre, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
S. H. Fox
Affiliation:
Movement Disorders Centre, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
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Abstract

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Background:

Current Health Canada instructions for use of the dopamine agonists (DA), pramipexole and ropinirole, state that Parkinson's disease (PD) patients should be told not to drive. The objective was to assess neurologists' actual clinical practice concerning driving advice they give to PD patients starting a DA.

Methods:

An online survey was created consisting of 4 items regarding demographics, 5 regarding PD and driving, and 9 regarding DA use and driving. The survey was distributed to 563 neurologists.

Results:

In total 96 neurologists (17.9%) responded. 4.4% tell patients with PD not to drive, solely because they are taking a DA. Respondents assess the patient's tendency for excessive daytime sleepiness and sleep attacks after starting a DA more frequently than after starting other dopaminergic drugs (p<0.001).

Discussion:

A minor proportion of the clinicians responding to our survey advise PD patients not to drive, solely because they use a DA. Such being the case, we propose that current Health Canada guidelines need revision.

Résumé:

RÉSUMÉ:<span class='italic'><span class='bold'>Contexte</span></span>:

Les directives de Santé Canada concernant l’utilisation des agonistes de la dopamine (AD),soit le pramipexole et le ropinirole, mentionnent qu’on devrait dire aux patients atteints de la maladie de Parkinson (MP) de ne pas conduire s‘ils prennent ces médicaments. Le but de cette étude était de vérifier ce que les neurologues conseillent en clinique à leurs patients atteints de la MP lorsqu’ils commencent à prendre un AD.

<span class='italic'><span class='bold'>Méthodes</span></span>:

Nous avons effectué une enquête par courrier électronique dont 4 items portaient sur la démographie, 5 sur la MP et la conduite automobile, et 9 sur l’utilisation d’un AD et la conduite automobile. Le questionnaire a été envoyé à 563 neurologues.

<span class='italic'><span class='bold'>Résultats</span></span>:

96 neurologues ont répondu au questionnaire (17,9%). Parmi eux, 4,4% disent à leurs patients atteints de la MP de ne pas conduire parce qu’ils prennent un AD. Les répondants vérifient plus souvent si les patients ont tendance à présenter une somnolence diurne excessive et des attaques de sommeil lorsqu’ils commencent à prendre un AD plutôt qu’un autre médicament dopaminergique (p > 0,001).

<span class='italic'><span class='bold'>Discussion</span></span>:

Une faible proportion des cliniciens qui ont participé à notre enquête prévient leurs patients de ne pas conduire simplement parce qu’ils prennent un AD. Devant cet état de fait, nous suggérons que les lignes directrices actuelles devraient être révisées.

Type
Original Articles
Copyright
Copyright © The Canadian Journal of Neurological 2007

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