Changes of medication after discharge from hospital in people with Parkinson’s Disease

Published: 30 June 2020| Version 1 | DOI: 10.17632/jfxsrzv98y.1
Contributor:
Tino Prell

Description

A self-report adherence to medication questionnaire as well as several clinical parameters were assessed in patients with Parkinson´s disease (PD) during their stay in the hospital. A short telephone interview was performed one month after discharge from hospital to detect the extent and reasons for changes of medication. This study was approved by the local ethics committee of the Jena University Hospital (4572-10/15). All subjects gave written informed consent in accordance with the Declaration of Helsinki. The inclusion criteria were PD diagnosis according to Movement Disorder Society (MDS) diagnostic criteria. Reasons for admission were, among others, an increase of fluctuations, worsening of dyskinesias, increase of off-phases, evaluation for deep brain stimulation, and worsening of gait and freezing. Patients with delirium or inability to complete a questionnaire were excluded. All tests were conducted during the medication ON phase. The demographic data collected included age, gender, marital status, level of education and employment status. Several clinical parameters were recorded:, the levodopa equivalent daily dose (LEDD), the MDS-sponsored revision of the Unified Parkinson's Disease Rating Scale III (MDS-UPDRS III), the revised non-motor symptoms questionnaire (NMS-Quest), and Hoehn & Yahr staging, the Montreal Cognitive Assessment and Beck’s depression inventory II. Adherence was assessed using the German Stendal Adherence with Medication Score (SAMS). It includes 18 questions forming a cumulative scale (0–72) in which 0 indicates complete adherence and 72 indicates complete nonadherence (15). The SAMS allows the assessment of three common reasons for/clusters of non-adherence: modification of medications, forgetting to take the medications, and lack of knowledge about the medications (16). The whole copy of SAMS is available online (CC BY NC 3.0 licence; https://data.mendeley.com/datasets/ny2krr3vgg/1) (17). The follow-up was set up as a semi-structured telephone interview 4 weeks after being discharged, which included the following questions. 1) Was the prescribed medication changed since discharge from hospital? (yes; no) 2) What was changed? (decrease in dosage; increase in dosage; change of drug; not specified change in medication) 3) Who changed the medication? (general practitioner (GP); outpatient neurologist; patient) 4) Why was medication changed? (medication run out‎/no prescription; missing/insufficient effect; missing knowledge about indication; side effects; others) There were three attempts to call the patient. The total number of patients recruited for the study was 130. For five patients a follow-up interview could not be performed. The dataset belongs to the paper: Self-reported Non-adherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson’s Disease. Francis Feldmann, Hannah M. Zipprich, Otto W. Witte, Tino Prell. Park Hindawi. 2020

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Parkinson's Disease, Health Services Research, Medication Adherence, Neurology

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