Session Information
Date: Monday, June 20, 2016
Session Title: Quality of life/caregiver burden in movement disorders
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To investigate whether a structured medication review executed by a community pharmacist improves medication adherence and influences quality of life in patients with Parkinson’s disease (PD).
Background: PD treatment is symptomatic and frequently consists of a large number of medications, taken several times a day. Complex schedules can negatively influence therapy adherence, resulting in a suboptimal treatment and a decreased quality of life. A structured medication review is a way to simplify and optimize complicated medication schedules possibly resulting in an improved quality of life.
Methods: This randomised controlled study was conducted in two general hospitals in the Netherlands. Patients were included in the period from May 2014 until December 2015. Inclusion criteria were; age ≥ 18 years, ≥ 4 different medications per day, ≥ 4 different medication intake moments daily and living (semi)-independent. The intervention consisted of a structured medication review (according to the Royal Dutch Pharmacists Association guidelines) performed by community pharmacists. The primary outcome was PD-specific quality of life (PDQ-39, scores range from 0 the best to 100 the worst). The minimally important differences determined by Peto et al. were used. Measurements were performed at 3 and 6 months of follow up.
Results: A total of 66 patients were included with a mean age of 71.5 (SD ± 6.1) years, 5.2 (SD ± 1.5) medication intake moments daily and 8.1 (SD ± 2.8) different medications per day. After six months of follow up there was a clinically, but not statistically significant difference between the intervention and control group in the outcomes of the PDQ-39 in the domains emotional well-being, cognitions, pain and overall score, however all in favour of the control group.
| Domain | Control group at baseline (SE) | Change from baseline after 6 months (SE) | Intervention group at baseline (SE) | Change from baseline after 6 months (SE) | Overall difference in change (intervention group – control group) after 6 months (SE)* | 95% confidence interval (Δ6 months – baseline) | p-value |
| Mobility | 45.3 (3.5) | -1.0 (2.4) | 45.6 (5.6) | 2.1 (2.2) | 1.8 (3.4) | -5.0 : 8.6 | 0.596 |
| Activities of daily living | 43.9 (3.6) | 2.3 (1.9) | 39.8 (5.3) | 4.7 (2.6) | 2.7 (3.1) | -3.6 : 9.0 | 0.393 |
| Emotional well-being | 31.1 (3.1) | 0.8 (1.8) | 31.0 (4.0) | 6.0 (3.1) | 6.3 (4.1)** | -1.9 : 14.6 | 0.131 |
| Stigma | 20.7 (2.7) | -1.7 (2.5) | 26.5 (3.5) | 0.8 (3.7) | 2.0 (3.8) | -5.6 : 9.6 | 0.601 |
| Social support | 22.2 (3.1) | -0.5 (2.7) | 25.3 (5.1) | 7.1 (3.9) | 4.4 (4.1) | -3.9 : 12.6 | 0.297 |
| Cognitions | 36.6 (3.4) | 0.2 (2.1) | 38.3 (3.2) | 6.3 (4.0) | 3.3 (3.2)** | -3.1 : 9.7 | 0.309 |
| Communication | 29.3 (3.0) | -0.8 (2.2) | 33.3 (4.4) | 4.0 (5.1) | 0.5 (3.6) | -6.8 : 7.8 | 0.886 |
| Pain | 49.0 (3.2) | 1.6 (2.5) | 47.0 (3.8) | 0.3 (3.4) | 4.1 (3.8)** | -3.6 : 11.7 | 0.290 |
| Overall score | 36.8 (2.3) | 0.1 (2.5) | 37.4 (3.3) | 3.8 (2.1) | 3.1 (2.1)** | -1.1 : 7.3 | 0.148 |
Conclusions: Quality of life in PD patients did clinically significantly decrease six months after performing a structured medication review executed by community pharmacists in the domains emotional well-being, cognitions, pain and overall score. Further details about cost-effectiveness will be analysed and supplied.
To cite this abstract in AMA style:
A. Verbeek, N. Oonk, E. Munster, K. Movig, K. ter Huurne, H. Nijmeijer, J. van der Palen, L. Dorresteijn. The effect of a structured medication review on quality of life in patients with Parkinson’s disease. An interim analysis [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/the-effect-of-a-structured-medication-review-on-quality-of-life-in-patients-with-parkinsons-disease-an-interim-analysis/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effect-of-a-structured-medication-review-on-quality-of-life-in-patients-with-parkinsons-disease-an-interim-analysis/