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Use of a VA Pharmacy Database to Screen for Areas at High Risk for Disease: Parkinson’s Disease and Exposure to Pesticides

Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Palo Alto VA Health Care System, Palo Alto, CA 94304;Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California yesavage{at}stanford.edu

J. Sheikh, MD

Palo Alto Veterans Affairs Health Care System, Palo Alto, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

A. Noda, MS

G. Murphy, MD, PhD

R. O’Hara, PhD

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

R. Hierholzer, MD

M. Battista, PhD

Central California Veterans Affairs Health Care System, Fresno; University of California at San Francisco

J. W. Ashford, MD, PhD

Palo Alto Veterans Affairs Health Care System, Palo Alto, California University of California at San Francisco

H. C. Kraemer, PhD

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

J. Tinklenberg, MD

Palo Alto Veterans Affairs Health Care System, Palo Alto, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

The purpose of this study was to assess whether pharmacy database information from US Department of Veterans Affairs (VA) medical centers could be used to screen for areas of higher Parkinson’s disease prevalence in patients exposed to pesticides. The authors used pharmacy data sets and compared the use of antiparkinsonian medications at 2 VA medical centers in California: one in Palo Alto, near the ocean, and one in Fresno, downwind from extensively farmed parts of the Central Valley. They found that patients at Fresno had higher odds ratios (1.5-1.8) for the use of Parkinson’s disease medications than patients at Palo Alto. These data are consistent with the observations of prior epidemiologic studies and suggest that VA pharmacy databases can prioritize locations for further epidemiologic research. However, a thorough exploration of alternative explanations is needed to reach definitive conclusions regarding the findings suggested by this method.

Key Words: pesticides • pharmacy database • Parkinson’s disease • epidemiology

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				J. A. Yesavage, J. Sheikh, A. Noda, G. Murphy, R. O'Hara, R. Hierholzer, M. Battista, J. W. Ashford, B. Schneider, J. Hoblyn, et al. Spatial Test for Agricultural Pesticide "Blow-In" Effect on Prevalence of Parkinson's Disease J Geriatr Psychiatry Neurol, March 1, 2006; 19(1): 32 - 35. [Abstract] [PDF]