Session Information
Date: Thursday, June 23, 2016
Session Title: Parkinson's disease: Clinical trials, pharmacology and treatment
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: The aim of this randomized controlled study was to assess the effect of the electronic medication dispenser, Medido, on physical limitations in PD.
Background: Complex medication schedules in PD result in a lower therapy adherence. This contributes to suboptimal therapy and clinical deterioration. Medication reminder systems might improve therapy adherence and subsequently improve symptoms of PD.
Methods: PD patients with inclusion criteria age>40, a minimum of 4 moments of medication intake each day and experiencing on-off fluctuations, were randomized into the Medido group or the control group. The primary outcome ‘physical disability’ was measured by the AMC Linear Disability Scale (ALDS). Score ranges from 0 (worst) to 100 (best). Secondary outcomes were QoL (PDQ-39; 39 items, 0 best, 100 worst), experienced health status (EQ5D, VAS), non-motor symptoms (NMS-Quest), late motor symptoms (MDS-UPDRS-4) and QoL of the caregiver (PDQ-carer). Measurements were performed at baseline, 3 and 6 months follow-up.
Results: Seventy-eight patients were randomized. A non-significant improvement of 3.0 points (95% CI -5.6;11.6) was seen in ALDS after 6 months in the Medido group compared to the control group. In exploratory sub analyses, patients with H&Y classification >2.5 improved significantly with 14.7 points on ALDS compared to the control group (CI -28.5;-0.9, p=0.029). Numerically beter scores were seen in age >70 years (5.28 points, CI -20.7;10.1), disease duration >5 years (8.23 points, CI -21.7;5.2) and when not receiving help from a caregiver (7.82 points, CI -18.7;3.0). Overall, QoL in PDQ-39 deteriorated 1.0 (p=0.01), which was largely attributed to deterioration on stigma domain (12.5, p=0.125). This effect was particularly seen in H&Y<2.5 and patients <70 years. Patients >70 years improved in the domain cognition and significantly in emotional wellbeing (5.1 points, CI -4.9;15.09, p=0.016). The MDS-UPDRS-4 shows a tendency towards reduced frequency and a smaller amplitude of the on-off fluctuations when using the Medido. Overall, no effect was observed on VAS, EQ5D, NMS-quest and PDQ-carer scales.
Conclusions: Use of the Medido results in a clinical improvement of physical disability and seems particularly appropriate for the older and more severe patient. Stigmatisation offsets the clinical effects in the younger, uncomplicated patient.
To cite this abstract in AMA style:
K. Hannink, L. ter Brake, A. Wertenbroek, K. Movig, J. van der Palen, L. Dorresteijn. Efficacy and feasibility study of the Medido eletronic medication dispenser in Parkinson’s disease: A multicentre randomized controlled trial [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/efficacy-and-feasibility-study-of-the-medido-eletronic-medication-dispenser-in-parkinsons-disease-a-multicentre-randomized-controlled-trial/. Accessed September 7, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-and-feasibility-study-of-the-medido-eletronic-medication-dispenser-in-parkinsons-disease-a-multicentre-randomized-controlled-trial/