Objective: Improvement of on-off symptoms in ambulatory patients with Parkinson’s disease (PD) by introduction of a multi-faceted medication optimization program. This consisted of a patient centered, pharmacist-led medication review with focus on non-adherence and introduction of automatic dispensed unit dose per time (Unit dose or baxter system) combined with a Parkinson’s KinetiGraph (PKG): an accelerometer with and without alarm-system[1][2].

Background: Many PD patients need 2 – 4 anti-Parkinson drugs four times or, in advanced stage disease, up to seven times a day. Non-motor symptoms give rise to an even higher pill burden. However, despite the importance of medication in Parkinson therapy, patients with PD are often non-adherent to medication and drug related problems occur often.

Methods: A single centre, prospective, observational pilot study on outpatient PD patients was excecuted, where usual care was compared with 3 types of interventions to optimize pharmacotherapy and improve drug adherence. Each patient served as his or her own control. Analysed were motor functioning (diary) and QoL (PDQ8) at 6 (usual care), 10 (unit dose (U)), 14 (U + PKG alarm (U+P)) and 20 weeks: U + P + review interventions.

Results: 23 included patients had a mean age of 67 years, 39% were female and 39% had Deep Brain Stimulation. They had 10.3 years the diagnosis and 52% had one affected cognitive domain. Patients used an average of 8 chronic drugs, 3 were for PD. A significant improvement in on-time without troublesome dyskinesia was seen after U+P (2.0 hrs. extra on-time/day, p=0.008), whereas addition of a review did not change this favourable outcome, which was still significantly better as compared to usual care (1.6 hrs. extra on-time/day, p=0.04). Also, off-time and dyskinesia showed a trend for improvement after all 3 interventions, which did not reach statistical difference. Finally after review intervention introduction a significant difference in PDQ8 score vs. U+P was reached (p=0.01).

Conclusions: These results support the introduction of a clinical pharmacist in an outpatient neurology clinic, which improves QoL, supported by an increased on-time by introduction of PKG with its alarm function. Further analysis is needed to determine effects of these interventions on non-motor symptoms.

21th World Congress on Parkinson’s disease and Related Disorders – Milaan, Italy on 15 patients included.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-pharmacist-led-interventions-on-motor-symptoms-and-quality-of-life-in-parkinsons-patients-a-pilot-study/