Objective: Review if admissions of People with Parkinson’s(PwP) to hospital is directly related to their Parkinson’s symptoms. Assess if medications are received on time. Explore if Length of Stay(LoS) differs for PwP and general population.

Background: PwP are frequently older, frailer and more likely to be admitted to hospital. They also have a higher chance of being discharged to a care setting than peers. Getting timely medications in hospital settings can be challenging for PwP.

Methods: We assessed all inpatient records of PwP admitted over 2 consecutive months to a University Hospital using pharmacy dispensing records and active case finding. Clinical notes, prescription charts and Electronic Health Records were accessed. Reasons for admission, medication administration, frailty scores, co-morbidities and LoS were recorded.

Results: A total of 41 patients (average age 78) were studied of which 29 were male. Average clinical frailty score and Charlson Co-morbidity Index were around 5. Less than half (17/41) the patients had Parkinson’s as their primary cause of admission. 46 % of first prescriptions were inaccurate for Parkinson’s medications. PwP had an average LoS of 28 days compared to 8.6 for an unselected inpatient population. Total number of prescribed doses were 3339 of which 186 (5.6%) were not administered. Only one in three patients did not miss any doses. Whilst 18% of all doses were missed in the first seven days of admission, a significant proportion was still being missed further into the admission. Only 13/43 patients were referred to Parkinson’s specialist team whilst inpatient. Self medicators did not miss any doses but only 2/9 had cognitive assessment. Average length of stay when no doses were missed 20 days compared to 32 days for patients with missed doses.

Conclusions: LoS of PwP is more than 3 times that of the average cohort in hospital. PwP appear to have poor access to Parkinson’s specialist care as inpatient. They also experience a significant number of adverse events in the form of prescription errors and missed doses especially in their first week of care. Self medication should be considered for more patients following cognitive assessment.Subsequent work is focussed on the development of an electronic trigger system to alert the Parkinson’s team to target the identified issues.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/acute-admissions-in-people-with-parkinsons-more-than-just-frailty/