Objective: Evaluate an inpatient intervention to reduce rates of hospital related complications in hospitalized patients with Parkinson’s disease (PD).

Background: Several interventions have been suggested to reduce known hospital complications in hospitalized PD patients but data driven recommendations are limited in the literature.

Method: A hospital wide alert system was incorporated into the EMR of Dignity Health affiliated hospitals in Arizona. Extensive in-services were done with providers and staff. Charts of subjects with PD admitted 6 months before and after the intervention were reviewed for baseline demographics, compliance with the intervention, and outcomes.

Results: 73 patients (mean age 73.2 years, mean disease duration 7.2 ± 9.1 years) in the pre-intervention group, 103 patients (mean age 72.3 years, mean disease duration 7.0 ± 6.4 years) in the post-intervention group were included. There were no significant differences among reasons for admission, admission to neurological vs non-neurological floor, or the service the patients were admitted to between the groups. The percentage of patients for whom contraindicated medications ordered decreased from 42.5% to 17.5% (p<0.001). Medication administration within 30 minutes of scheduled time increased from 46% to 53%, and doses given over 30 minutes went from 46% to 39% (p=0.068). Medications ordered by home schedule were 42.9% vs 54.7% (p=0.131) before and after the intervention. Length of stay was 5.3 vs 5.2 days (p=0.896) and mean number of complications was 0.38 vs 0.37 (p=0.864).

Conclusion: An intervention involving EMR alerts and in-service didactics decreased the frequency of contraindicated medications ordered in hospitalized PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/improving-outcomes-in-hospitalized-parkinsons-patients/