Objective: The objective of this research was to explore the pivotal role of outpatient nurses in mitigating skin complications and facilitating uninterrupted treatment for Parkinson’s Disease (PD) patients treated with Foslevodopa/Foscarbidopa (LDP/CDP) therapy.

Background: The treatment involving LDP/CDP has been incorporated into the health insurance scheme in Japan since July 2023. It has been documented to induce a significant occurrence of dermatological conditions such as injection site infection, erythema, and nodules as adverse effects of the therapy1). Consequently, as it is crucial to circumvent skin complications during the continuation of treatment, we have investigated practical guidance and requisite support for outpatient nurses caring for PD patients undergoing LDP/CDP treatment.

Method: The content of guidance provided by outpatient nurses to patients who commenced LDP/CDP treatment and visited our outpatient clinic from July 2023 to February 2024 was analyzed, and potential issues that could escalate into complications were identified.

Results: This study involved 14 PD patients (13 inpatients and one outpatient), with an average age of 57.4±16.6 years and an average disease duration of 11.3±10.7 years. All 14 patients experienced erythema or nodules at the injection site. Five patients developed panniculitis, and three patients developed an infection at the infusion site. However, the onset time varied among individuals. Outpatient nurses followed patients an average of 1.7±0.7 times per month and provided instruction in 27 cases, averaging 1.9±3.1 times per case. The most common instruction was regarding the puncture site (9 cases), followed by puncture technique (5 cases), pre-puncture disinfection method (4 cases), and timing of needle exchange (4 cases). No correlation was found between the subject cases and factors such as age, cognitive function, severity of illness, or frequency of visits.

Conclusion: Despite the prevalence of skin complications caused by LDP/CDP treatment, none of the cases were discontinued due to these issues. Our results indicate that patient education, family guidance when necessary, consultations with dermatologists, and collaboration with home health nurses are the appropriate steps for managing skin troubles for LDP/CDP therapy.

References: 1) AbbVie data: Phase III study in patients with Parkinson’s disease (M15-741 study)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/preventing-treatment-disruptions-the-crucial-role-of-outpatient-nurses-and-multidisciplinary-collaboration-in-managing-skin-complications-during-foslevodopa-foscarbidopa-therapy/