Medication Adherence in People With Parkinson Disease

Abstract

Parkinson disease (PD) is the second most common neurodegenerative disorder in the United States. Because there is no cure for PD currently, pharmacological therapy is the mainstay of PD symptom management. Despite the importance of medication adherence in PD, several studies have reported medication nonadherence and/or suboptimal adherence. This literature review provides an overview of medication adherence issues in people with PD. Articles were identified for this study using computerized database searches and journal hand searches. Of the 72 medication adherence articles reviewed, the following articles were eligible for this review: (a) 10 articles measuring medication adherence in people with PD, (b) four medication adherence intervention articles, and (c) six studies of medication adherence in hospitalized settings. The importance of adherence assessment and strategies in improving medication adherence are discussed with the goal of improving symptom management and clinical outcomes in people with PD. Because medication taking is a complex and multifaceted phenomena, patient-centered, theory-driven interventions are needed to improve medication adherence and quality of care and life in people with PD.

What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

“…Medication adherence in PD, defined as taking >80% of the prescribed dose, ranged widely from 33 to 97.7% in previous studies (11). The prevalence mainly depends on the method used to assess adherence and the study design.…”

“…There are various reasons as to why people do not or cannot follow the instructions they are given for prescribed treatments. Systematically, the factors associated with adherence to medications can be divided into patient characteristics, disease-related factors, financial and health system barriers, patient-provider relationship factors, and treatment-related factors (10,11). Patient-related factors can be further categorized as intentional (when the patient purposefully decides not to adhere to the recommended treatment) or unintentional (when the patient cannot follow the recommendations).…”

“…Patient-related factors can be further categorized as intentional (when the patient purposefully decides not to adhere to the recommended treatment) or unintentional (when the patient cannot follow the recommendations). Several studies and reviews explored epidemiological and clinical factors associated with nonadherence to medication in PD, such as younger age, education level, marital status, mood disorders, cognition, disease duration, and regimen complexity (2,4,6,11,12). However, the sample size in many studies was low (2), or, as in a large study by Valldeoriola et al, cognition as an important cofactor was not assessed in detail (it was graded according to a four-point scale).…”

Prevalence of Parkinson’s disease in an urban area of Cienfuegos city

“…The utilized methods for the estimate of the prevalence can be classified in three groups: community studies based on the cases taken care of in the medical consultations; studies door to door, that are capable of detecting up to 40% of new cases; and the studies of utilization of drugs, 11 as the one carried out by us, a method which is effective and easy to apply, specifically in a disease as the PD where the Levodopa is the most effective drug and is not utilized in another disease. 12 The prevalence index (PI) in 357.1/100000 for PD found in our study remains above the mean of the different studies consulted in the bibliography, basically European, [13][14][15][16][17][18] becoming evident in addition that are kept men older than 65 years of age as the most affected, as in the majority of the studies although its incidence and prevalence of these is above the 70 years old. 19 Other works show a PI/100000 inhabitants higher than these figures as in a similar study carried out in China (522) and Sydney (776).…”

“…4 Numerous population studies have documented that Parkinson's disease is more common in the very industrialized countries that in the agricultural societies, and most frequent in Europe and North America that in the Far East. [5][6][7][8] The analysis joint of 5 European Communities did not identify any substantial difference in the prevalence of the EP in the European countries and the general prevalence was 1.6 per 100 population. The variable incidence rates in different cultures at least are partly related to the lack of uniform criteria for diagnosis.…”