Objective: To characterize health literacy (HL), medication adherence, satisfaction with medication information, and quality of life (QoL) in Parkinson’s disease (PD) patients undergoing the levodopa challenge test (LCT) due to subjective complaints about treatment response.
Background: The LCT is a tool used to identify discrepancies between objective motor improvement and subjective patient perception and to characterize levodopa-related complications, including dyskinesias and non-motor symptoms. Despite its clinical utility, the HL, adherence behaviors, and QoL profiles of patients referred for formal LCT evaluation remain poorly characterized.
Method: Thirty-one PD patients were recruited by a movement disorders specialist and underwent LCT for either a reported lack of subjective response or to characterize levodopa-related side effects. Objective motor response was assessed using MDS-UPDRS Part III. HL was measured using the Brazilian version of the European Health Literacy Questionnaire (HLS-EU-BR47), the Medication Adherence Rating Scale (MARS), and the Satisfaction with Information about Medicines Scale (SIMS). QoL was measured using the PDQ-39.
Results: The cohort (51.6% male; mean age 59.9±14.9 years) had a mean disease duration of 12.9±7.1 years and a mean daily levodopa dose of 578±403mg. LCT revealed a significant objective motor response, with MDS-UPDRS Part III scores improving from 66.6 at baseline to 44.5 post-dose (33.2% improvement, p<0.001), despite patients’ subjective complaints. Scores across patient-centered domains were only moderate: HL (23.4±3.3/50), adherence (MARS: 5.55±1.79/10), and medication information satisfaction (SIMS: 9.32±2.01/17). The mean PDQ-39 score was 32.0±9.4.
Conclusion: Despite objective motor response to levodopa, patients exhibited only moderate HL, medication adherence, and satisfaction with medication information. This disconnect suggests that subjective complaints may reflect gaps in patient education and health communication rather than pharmacological failure alone. Targeted interventions addressing these domains are needed to optimize comprehensive PD management.
To cite this abstract in AMA style:
M. da Silva, M. Tosin, L. Silveira-Moriyama. Beyond Motor Outcomes: Health Literacy, Medication Adherence, and Quality of Life in Parkinson’s Disease Patients Undergoing the Levodopa Challenge Test [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/beyond-motor-outcomes-health-literacy-medication-adherence-and-quality-of-life-in-parkinsons-disease-patients-undergoing-the-levodopa-challenge-test/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/beyond-motor-outcomes-health-literacy-medication-adherence-and-quality-of-life-in-parkinsons-disease-patients-undergoing-the-levodopa-challenge-test/