Objective: Our study aimed to determine the accuracy of initial prescribing on hospital admission and the subsequent timing of administration of Parkinson’s disease (PD) medications for inpatients in a large tertiary centre.

Background: Parkinson’s disease is a movement disorder characterised by bradykinesia, with rigidity, tremor or postural instability. It is managed primarily with preparations of levodopa, as well as dopamine agonists. The administration of these medications is time critical due to the short half life of dopamine, and its high protein binding.

Method: This was a retrospective cross-sectional study of 160 admissions of PD patients between November 1^st 2018 and March 1^st 2020, of which 102 admission met inclusion criteria. Information was obtained for each admission regarding prescribing of time-critical PD medications on admission. Additional information was obtained from a subset of 46 admissions, whose duration was less than 21 days, regarding timing of administration of PD medications.

Results: Errors in prescribing of time-critical PD medications were made in 50% of admissions, with the majority of these pertaining to timing (31.6%). Other types of errors noted involved omission, dose, substitution and formulation errors. Male sex, the number of PD medications prescribed on admission and the number of administrations required were significantly associated with errors in admission prescribing.
In terms of accuracy of administration timing for these time-critical medications, medications were omitted only 7.5% of the time. However, they were given outside 30 minutes of scheduled time (contrary to NICE guidance) 51.7% of the time.

Conclusion: Patients with Parkinson’s disease who undergo unplanned admission to hospital are at risk of prescribing errors and medication administration errors. Given the demonstrable effect such errors have on patient mortality and length of stay, it is essential that further work is undertaken to reduce this risk.(1)

References: 1. Lertxundi, Unax, et al. “Medication errors in Parkinson’s disease inpatients in the Basque Country.” Parkinsonism & related disorders 36 (2017): 57-62.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-medication-safety-in-the-inpatient-cohort-of-a-tertiary-centre/