Objective: To determine if there are differences in timely administration of medications in hospitalized patients with Parkinson’s Disease (PD) when orders are placed for a “custom” schedule compared to a standard, non-custom schedule.

Background: Patients with PD are more susceptible to hospital-acquired complications, and more extended hospital stays. This increased risk is related to delays or omissions in administering PD medication or administration of contraindicated medications. These errors occur as most providers are unaware of the importance of timing of PD medications and adherence to home schedules.
A protocol was developed for adherence to a “customized” schedule when ordering PD medications launched in 2018. In addition to a hospital-wide education program, orders for PD medications are tracked to assess if “custom” or standard, non-custom schedules were placed. Here we report data on 31,404 doses of PD medications administered over five years.

Method: A retrospective review on PD medication orders placed from 01/02/2016 to 4/30/2021 was performed. The primary outcome of interest was the difference in administration time relative to the due time between the “Custom” ordered medications and the Non-Custom group. Comparisons of frequency of medications administered on schedule (i.e., within 1 minute of medication due time) were modeled using multivariable logistic regression. Comparisons of median differences in administration time relative to due were modeled using quantile regression. Multivariable models were selected based on best subset selection using the Akaike information criterion to select the final model.

Results: The final analysis set consisted of 31,404 PD medication orders (Custom group: n=14,204 [45.23%]; Non-Custom group: 17,200 [54.77%]) recorded from 01/02/2016 to 4/30/2021. (fig 1.) On multivariable logistic regression, the odds of medications being administered on time were significantly greater in the Custom group compared to the Non-Custom group (Odds Ratio=1.67 [95% CI: 1.47 – 1.90], p<0.001). On quantile regression adjusted for the time of medication order, the Custom group had significantly lower differences in time to medication relative to medication due times, with a median difference of 2.71 minutes (95% CI: 1.70 – 3.71, p<.001). (Table1, Figure 2)

Conclusion: Placing medication orders in a “custom” schedule improves the  timeliness of administration compared to non-custom orders.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/improving-timely-administration-of-pd-meds-in-the-hospital-by-using-custom-schedules/