Objective: Explore the relationship between objective and patient-reported assessment of cognition to patient-reported medication management capabilities.

Background: Parkinson’s disease (PD) is a complex neurodegenerative disorder characterized by cognitive, psychiatric and motor dysfunction. Pharmacotherapy management of symptoms is the most common intervention and medication regimens can be complicated, burdensome, and change as disease evolves. Cognitive impairment in people with PD (PwPD) may adversely impact the capacity for independent medication management. Accurate identification of the degree and type of cognitive impairment (CI) may enhance the provider’s ability to assess appropriate medication adherence. Clinicians’ accurate recognition of CI in PwPD might be problematic.

Method: Retrospective review of data collected through routine care of PwPD that were evaluated by multidimensional computerized cognitive testing and completed patient reported outcomes (PROs): Self-Efficacy for Managing Medications and Treatments Short Form 4a (MM) and PROMIS Applied Cognition- Abilities- Short Form 4a (AC). Cognitive domains collected were: Memory (MEM), Executive Function (EF), Visual Spatial (VS), Information Processing (IP), Verbal Function (VF), Attention (ATT) and a Global Cognitive Summary Score (GCS).

Results: 90 PwPD, 64% male, average age 73+/- 9. Significant relationships were identified by regression analysis (p<0.05) for the following: MM and GCS (r² = 0.41), MM vs AC (r² = 0.29). 31% of PwPD reported low confidence in self-managing medications (37% of males and 21% of females).

Conclusion: Low confidence in medication management in PwPD might be more common than appreciated. Independent management of medications declines with increased cognitive impairment.  Objective multi-domain cognitive assessment provides a better appreciation of CI and the relationship to medication management than does PRO-CI perception. Examiner independent quantified cognitive assessment provides added value in identifying the need for assistance in medication management for PwPD to increase adherence to prescribed medication schedules, treatment need and perhaps optimizing care plans.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-cognitive-function-and-medication-management-a-problem-in-routine-care/