Objective: To find out whether pill box organizers with alarm would improve the rate of adherence in non-adherent patients with Parkinson’s disease (PD) taking three and more daily doses of antiparkinsonian drugs, and whether the improvement of adherence to pharmacotherapy affects the clinical parameters.

Background: Non-adherence to pharmacotherapy in chronic disorders is a very important healthcare problem. In PD patients, it is associated with motor and non-motor complications and reduced quality of life (QoL). Therefore, improvement of adherence to pharmacotherapy is a challenge in routine clinical practice. Previous data about an effect of dosing devices in chronic disorders were inconsistent, and this issue has not been investigated in PD.

Method: We included 96 non-demented subjects with idiopathic PD. We used validated Slovak versions of questionnaires and scales: 8-Item Morisky Medication Adherence Scale (MMAS-8), the Parkinson’s Disease Questionnaire-8 (PDQ-8), Geriatric Depression Scale (GDS), Non-motor Symptom Assessment Scale for Parkinson’s Disease (NMSS), 9-Item Wearing-off Questionnaire (WOQ-9), MDS-UPDRS parts III and IV. In our pilot study, non-adherent patients (≥3 points in the MMAS-8) received a pill box organizer with alarm at baseline visit, and they underwent follow-up visit after 6 weeks. We used Student T-test to determine the effect of our intervention.

Results: We involved 40 patients with PD (26 males) with mean age of 66.6 ± 9.2 years, median of Hoehn &Yahr stage was 2.5 (range 1-4), an average number of daily doses of PD drugs was 5.3 ± 1.1 with average levodopa equivalent dose 1379.1 ± 542.9 mg. In the 6-week period, the pill box organizer with alarm had significant effect on the increasing the rate of adherence (MMAS-8, p < 0.001), and the trend in improving motor and non-motor fluctuations (WOQ-9, p = 0.058) was identified.

Conclusion: Complex therapeutic regimens are associated with lover adherence. It is necessary to develop devices for improving adherence. In non-adherent PD patients who take three and more daily doses of antiparkinsonian drugs, introduction of a pill box organizer with alarm seems to be a promising in improving the rate of adherence. Moreover, it may potentially contribute to an improvement or alleviation of motor and non-motor complications.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-pill-box-organizers-with-alarm-on-improvement-of-adherence-to-pharmacotherapy-in-patients-with-parkinsons-disease-a-pilot-study/