Objective: To evaluate the impact of comorbidities and compliance iniciatives on treatment efficacy in patients with Parkinson’s disease.

Methods: In the year 2014 we included 52 symptomatic consecutive patients (mean age 58.3±5.7 years) with early Parkinson’s disease and initial pharmacotherapy of levodopa+dopamine agonists and neuroprotection. Physical examination, laboratory tests, CT scan were performed at baseline. We examined compliance initiatives every month during 1-year period after 1st admission to clinic.

Results: 22(42.3%) patients were strictly compliant with pharmacologic therapy, diet, life style changes, 30/52 patients (56.7%) were non-compliant with no improvement in treatment. At baseline prevalence of depressive disorders, dysthymia, severity of gate and mental health disorders were comparable in both groups. 1-year treatment in compliant group resulted in a daily off time reduction (−43.7%; from 2.71±0.71 to 1.52±0.44 h/day; 95%CI from 0.83 to 1.55, p=0.0001). Among non-compliant patients forgetfulness was in 14(46.7%) patients, lack of financial support to buy medications was in 11(36.7%), adverse effects in 3(10%) cases, patients’ reluctance to take medication for long lime was in 6(20%) patients. We found differences in comorbidities in groups presented in Table.

Comorbidities in early Parkinson’s disease patients (compliant vs. non-compliant group)

Parameters	Compliant group, n=22	Non-compliant group, n=30	P value
Arterial hypertension	6(27.3%)	9(36.6%)	1.0
Orthostatic hypotension	4(18%)	6(20%)	1.0
Hyperlipidemia	11(50%)	27(90%)	0.034
Coronary artery disease	9(41%)	25(83.3%)	0.027
Type 2 diabetes	1(4.5%)	9(36.6%)	0.0316
Atrial fibrillation	1(4.5%)	4(13.3%)	1.0
Ventricular arrhythmia	1(4.5%)	9(36.6%)	0.0316
Congestive heart failure	7(31.8%)	16(53.3%)	0.162

” Compliant patients during 1-year examination period had no occurrence of major adverse cardiovascular events (MACE) as myocardial infarction (MI), fatal arrhythmias or cardiac death. 4/30 non-fatal MI occurred in non-compliant group with obstructive CAD. Patients with type 2 diabetes, coronary artery disease (CAD), hyperlipidemia and arrhythmias had more severe general condition, higher frequency of hospitalizations, costs of treatment, and more complex medication regime.

Conclusions: Compliant group showed decline of motor symptoms and preserve quality of life. Comorbidities such as coronary artery disease, diabetes and hyperlipidemia showed differences in compliant initiatives.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-comorbidities-and-compliance-initiatives-in-management-of-patients-with-early-parkinsons-disease/