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The effect of a structured medication review on quality of life in patients with Parkinson’s disease. An interim analysis

A. Verbeek, N. Oonk, E. Munster, K. Movig, K. ter Huurne, H. Nijmeijer, J. van der Palen, L. Dorresteijn (Eerbeek, Netherlands)

Meeting: 2016 International Congress

Abstract Number: 532

Keywords: Pharmacotherapy

Session Information

Date: Monday, June 20, 2016

Session Title: Quality of life/caregiver burden in movement disorders

Session Time: 12:30pm-2:00pm

Location: Exhibit Hall located in Hall B, Level 2

Objective: To investigate whether a structured medication review executed by a community pharmacist improves medication adherence and influences quality of life in patients with Parkinson’s disease (PD).

Background: PD treatment is symptomatic and frequently consists of a large number of medications, taken several times a day. Complex schedules can negatively influence therapy adherence, resulting in a suboptimal treatment and a decreased quality of life. A structured medication review is a way to simplify and optimize complicated medication schedules possibly resulting in an improved quality of life.

Methods: This randomised controlled study was conducted in two general hospitals in the Netherlands. Patients were included in the period from May 2014 until December 2015. Inclusion criteria were; age ≥ 18 years, ≥ 4 different medications per day, ≥ 4 different medication intake moments daily and living (semi)-independent. The intervention consisted of a structured medication review (according to the Royal Dutch Pharmacists Association guidelines) performed by community pharmacists. The primary outcome was PD-specific quality of life (PDQ-39, scores range from 0 the best to 100 the worst). The minimally important differences determined by Peto et al. were used. Measurements were performed at 3 and 6 months of follow up.

Results: A total of 66 patients were included with a mean age of 71.5 (SD ± 6.1) years, 5.2 (SD ± 1.5) medication intake moments daily and 8.1 (SD ± 2.8) different medications per day. After six months of follow up there was a clinically, but not statistically significant difference between the intervention and control group in the outcomes of the PDQ-39 in the domains emotional well-being, cognitions, pain and overall score, however all in favour of the control group.

Table 1: Repeated measurements analysis on the effect of a medication review on quality of life (QoL) in patients with PD using the PDQ-39.
Domain Control group at baseline (SE) Change from baseline after 6 months (SE) Intervention group at baseline (SE) Change from baseline after 6 months (SE) Overall difference in change (intervention group – control group) after 6 months (SE)* 95% confidence interval (Δ6 months – baseline) p-value
Mobility 45.3 (3.5) -1.0 (2.4) 45.6 (5.6) 2.1 (2.2) 1.8 (3.4) -5.0 : 8.6 0.596
Activities of daily living 43.9 (3.6) 2.3 (1.9) 39.8 (5.3) 4.7 (2.6) 2.7 (3.1) -3.6 : 9.0 0.393
Emotional well-being 31.1 (3.1) 0.8 (1.8) 31.0 (4.0) 6.0 (3.1) 6.3 (4.1)** -1.9 : 14.6 0.131
Stigma 20.7 (2.7) -1.7 (2.5) 26.5 (3.5) 0.8 (3.7) 2.0 (3.8) -5.6 : 9.6 0.601
Social support 22.2 (3.1) -0.5 (2.7) 25.3 (5.1) 7.1 (3.9) 4.4 (4.1) -3.9 : 12.6 0.297
Cognitions 36.6 (3.4) 0.2 (2.1) 38.3 (3.2) 6.3 (4.0) 3.3 (3.2)** -3.1 : 9.7 0.309
Communication 29.3 (3.0) -0.8 (2.2) 33.3 (4.4) 4.0 (5.1) 0.5 (3.6) -6.8 : 7.8 0.886
Pain 49.0 (3.2) 1.6 (2.5) 47.0 (3.8) 0.3 (3.4) 4.1 (3.8)** -3.6 : 11.7 0.290
Overall score 36.8 (2.3) 0.1 (2.5) 37.4 (3.3) 3.8 (2.1) 3.1 (2.1)** -1.1 : 7.3 0.148
Mean difference scores on baseline and at 6 months of follow up with the overall difference in change, 95% confidence interval and p-value. Outcomes of the PDQ-39 range from 0 (best QoL) till 100 (worst QoL). * A positive change is in favour of the control group. ** Exceeds the minimally important difference determined by Peto et al.“

Conclusions: Quality of life in PD patients did clinically significantly decrease six months after performing a structured medication review executed by community pharmacists in the domains emotional well-being, cognitions, pain and overall score. Further details about cost-effectiveness will be analysed and supplied.

To cite this abstract in AMA style:

A. Verbeek, N. Oonk, E. Munster, K. Movig, K. ter Huurne, H. Nijmeijer, J. van der Palen, L. Dorresteijn. The effect of a structured medication review on quality of life in patients with Parkinson’s disease. An interim analysis [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/the-effect-of-a-structured-medication-review-on-quality-of-life-in-patients-with-parkinsons-disease-an-interim-analysis/. Accessed June 14, 2025.
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