Objective: We developed a mobile application that converts dopaminergic medication dosages and calculates total Levodopa (L-dopa) equivalent daily dose (LEDD) in a Parkinson’s Disease (PD) patient’s complex pharmacologic regimen. It is comprehensive in that it also provides an easy reference to the most recent PD literature to facilitate the use of evidence-based medicine in the treatment of PD.

Background: L-dopa remains the gold standard in the treatment of PD. Due to variability and fluctuations in the response, PD patients often have complex pharmacologic regimens. With more advances in PD treatment, clinicians must often convert one dopaminergic medication to another. These calculations can be very time-consuming and error-prone, especially in a busy clinical setting.

Method: The application was prototyped using an online tool and then coded using an open-source programming language. We used a conversion formula for L-dopa equivalents that is based on the most recent study published in the literature [1]. We searched the PubMed database for randomized controlled trials in Parkinson’s Disease from 2008-2021 and summarized the conclusion for each trial. The calculator and trial data were inputted into the application. The prototype application (Figures 1-3) was tested in the clinical setting by physicians caring for PD patients at our institution and used as a control for manual calculations done by our clinicians.

Results: The application has been found to be resourceful and effective in the clinical setting.

Conclusion: This application could provide an efficient and reliable replacement to the time-consuming calculations required to convert one dopaminergic medication to another and total LEDD in the clinical setting. It can also provide a comprehensive reference to PD literature, which we hope will be a valuable resource for both neurology trainees and faculty and will facilitate the application of evidence-based treatment in patients with PD. The conversion provided by the application is a suggestion based on the best literature available and cannot predict the effect of any medication on individual patients. It is not meant to replace clinical judgement, which should be used before applying the results of this application in patient care.

References: [1] Nyholm, D., Jost, W.H. An updated calculator for determining levodopa-equivalent dose.Neurol. Res. Pract. 3, 58 (2021). https://doi.org/10.1186/s42466-021-00157-6

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pd-a-comprehensive-user-friendly-mobile-application-for-clinicians-treating-parkinsons-disease/