Objective: The objective was to analyse the effect of structured medication reviews (MR) in ambulatory PD patients on patient reported outcome measures (PROMS).

Background: Patients with Parkinson’s disease (PD) use many drugs for their disease. Furthermore, PD is associated  with substantial co-morbidities, adding up the number of medicines. This pill burden induces poor adherence, drug-related problems (DRPs) resulting in suboptimal improvement of their (non) motor-symptoms.

Method: A prospective, observational study was performed in a PD outpatient clinic, including consecutive PD patients for a structured MR, performed by a clinical pharmacist.  MR is the structured process where medicines are weighted in the context of a patient’s clinical condition and personal preferences. After a profound analysis, DRPs potentially inducing or deteriorating patient reported outcomes were discussed with the responsible healthcare professional and the patient.  Suggested interventions resulting from this MR were evaluated after 3 months, using PROMS based on the medical records.

Results: Overall 45 PD patients were included for a MR. At least one symptom was reported in all patients. In total 152 symptoms (1-6 per patient) were reported by these 45 patients, especially consisting of falls, fatigue, pain and orthostatic hypotension (36%).  After 3 months, 84 (55%) of the symptoms were solved, 23 (15%) partly solved, and 29 (19%) not solved. From  6 reported symptoms (3%) no information was available in the medical records after 3 months. The interventions consisted of providing adequate information (40x, 26%) and improved monitoring (37x, 24%), as well as stopping medication, which resulted in 18 cases (81% of all stopped medication) in a complete disappearance of symptoms.

Conclusion: Our data support the effectiveness of MR and the resulting interventions on PROMS in PD patients, performed by a clinical pharmacist at an outpatient PD clinic.

References: [1] L. H. Poon, A. J. Lee, T. B. Chiao, G. A. Kang, S. Heath, and G. A. Glass, “Pharmacist’s role in a Parkinson’s disease and movement disorders clinic.,” Am. J. Health. Syst. Pharm., vol. 69, no. 6, pp. 518–20, Mar. 2012. [2] C. Stuijt, F. Karapinar- Carkit, B. vd Bemt, and T van Laar, “Effect of Pharmacist-Led Interventions on (Non)Motor Symptoms, Medication-Related Problems, and Quality of Life in Parkinson Disease Patients: A Pilot Study” Clin.Neuropharm, vol. 41, pp. , Jan 2018.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-medication-review-on-reported-symptoms-in-parkinsons-disease-patients/