Objective: Study was aimed to detect extent of adherence to pharmacotherapy in patients with Parkinson´s disease (PD) who take three and more daily doses of dopaminergic drugs and to identify causes of low level of adherence.

Background: Adequate control of motor symptoms and quality of life are primary aims in the treatment of PD. Non-adherence to pharmacotherapy in PD is prevalent.

Methods: We included non-demented patients with idiopathic PD. We used validated Slovak versions of questionnaires and scales: 8-Item Morisky Medication Adherence Scale, the Parkinson´s Disease Questionnaire-8 (PDQ-8), Geriatric Depression Scale (GDS), Non-motor Symptom assessment scale for Parkinson´s Disease (NMSS), 9-Item Wearing-off Questionnaire (WOQ-9), MDS-UPDRS parts III and IV.

Results: We involved 124 PD patients (72 men, 52 women) with mean age of 66.7 ± 9.8 years old, mean Hoehn & Yahr stage of 2.4 ± 0.6 (range 1-4), and the average number of daily doses of PD drugs was 5.2 ± 1.3 (average levodopa equivalent dose was 1188.6 ± 551.8 mg). We detected that 33.9 % of subjects had high level of adherence, 29.8 % had medium level of adherence and 36.3 % had low level of adherence. We found out that the rate of non-adherence is correlated with male gender (Rho=0.180, p=0.045), disease duration (Rho=0.184, p=0.041), quality of life (PDQ-8; Rho=0.179, p=0.047), depression (GDS; Rho=0.272, p=0.002), motor complications (MDS-UPDRS IV; Rho=0.234, p=0.009), wearing-off severity (WOQ-9; Rho=0.277, p=0.002), and with non-motor symptoms frequency and severity (NMSS; Rho=0.346, p<0.001). The most important NMSS items were depression, forgetfulness and fatigue.

Conclusions: More than one third of PD patients taking three and more daily doses of antiparkinsonian drugs reported low adherence to their pharmacotherapy. Male patients, and those with severe motor fluctuations, fatigue, cognitive impairment and/or mood disturbances are more prone to lower level of adherence. It is also associated with poorer quality of life, thus stressing the need for active screening. Project was supported by research grant provided by Novartis Slovensko, s.r.o. and Grant UK/426/2016.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-associated-with-non-adherence-to-pharmacotherapy-in-patients-with-parkinsons-disease-who-take-three-and-more-daily-doses-of-dopaminergic-drugs/