Objective: Objective: Drug-disease interactions in Parkinson’s disease patients can give rise to situations where a drug may have negative effects on both motor- and non-motor functioning. In these situations, it can be necessary to avoid that drug, adjust its dose or monitor therapy.
Background: In the Netherlands, health care professionals have developed a best practice how to evaluate drug-disease interactions. The objective of this investigation is to describe and evaluate the pharmacological background and clinical relevance of alerts for drug-disease interactions for Parkinson’s disease (PD).
Method: Methods: We evaluated current potential alerts for drug-disease interactions by a structured literature search combined with practical experience from the center of excellence in Parkinson’s disease, Punt voor Parkinson, and review by a multi-disciplinary expert panel. We analyzed the number of drugs with proven drug-disease interactions, practice recommendations and underlying pharmacological mechanisms.
Results: Results: In total, of 70 drugs templates were developed for PD as interacting disease. The most important underlying mechanism for a drug disease interaction was interference with dopamine receptors, resulting in an increase in (non)-motor symptoms. The most common practice recommendation was to consider alternatives with less dopaminergic interference, and to inform patients about specific symptoms, if relevant in combination with monitoring (severity of) symptoms. Furthermore, recommendations were concretized by changing for example ‘monitor symptoms’ into ‘discuss with patient occurrence or deterioration of tremor/ataxia’. Examples of drugs with a drug-disease interaction were antipsychotics and lithium.
Conclusion: Conclusion: 70 drug recommendations were developed for drug-disease interactions between these drugs and PD. These recommendations will be further implemented in clinical decision support leading to alerts for clinically relevant drug-disease interactions at the point of care for physicians and pharmacists in primary care and hospitals.
To cite this abstract in AMA style:
JJ. de Jong, CCM. Stuijt, MME. Diesveld, T. van Laar, SD. Borgsteede. Medication safety in Parkinson’s disease patients: evaluation of recommendations for decision support in the national drug-disease interaction database [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/medication-safety-in-parkinsons-disease-patients-evaluation-of-recommendations-for-decision-support-in-the-national-drug-disease-interaction-database/. Accessed December 11, 2024.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/medication-safety-in-parkinsons-disease-patients-evaluation-of-recommendations-for-decision-support-in-the-national-drug-disease-interaction-database/