title: Adherence to antiparkinson medication in a multicenter European study.
abstract: Two small studies reported suboptimal therapy adherence in Parkinson's disease. We conducted a larger multicenter European study to assess medicine-taking behavior. Parkinson's disease patients taking dopaminergic therapy were enrolled in 8 centers in 5 countries, and disease severity and demographics recorded. Antiparkinson drug adherence was measured for 4 weeks using electronic monitoring bottles which record the date and time of cap opening (Aardex, Switzerland). One hundred twelve patients, mean age 65 years (standard deviation (SD) 10), with Parkinson's disease for 7.7 (SD 8.2) years completed the study. Total median adherence (doses taken/doses prescribed) was 97.7% (interquartile range [IQ] 90.6-100), days adherence (correct dose days) was 86.2% (IQ 61.1-96.2) and timing adherence (doses taken at correct time intervals) was 24.4% (IQ 5.3-56.5). Fourteen patients (12.5%) took less than 80% of prescribed doses, which was defined as suboptimal adherence. Patients with satisfactory adherence took a median of 8 mg/day (IQ 0-33) less than their prescribed dose of levodopa (P = NS), while suboptimal adherence patients took a median of 481 mg/day (IQ 205-670) less than their prescribed dose (P = 0.0006). The Parkinson motor score was significantly higher in patients with suboptimal adherence at 29 (IQ 20-40), versus those with satisfactory adherence at 19 (IQ 13-26), P = 0.005. Once daily drugs had significantly better adherence when compared with drugs prescribed more frequently (P < 0.0001). Suboptimal therapy adherence is associated with significant deviation from prescribed levodopa doses, despite greater Parkinson's motor severity. Optimizing oral medication intake has a potential role in maximizing the therapy response in Parkinson's disease.
authors.affiliation: Institute of Neurological Sciences, Southern General Hospital, Glasgow, United Kingdom.
authors.forename: Donald
authors.initials: D
authors.lastname: Grosset
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Margherita
authors.initials: M
authors.lastname: Canesi
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
authors.forename: Andrew
authors.initials: A
authors.lastname: Lees
authors.forename: Karen
authors.initials: K
authors.lastname: Shaw
authors.forename: Esther
authors.initials: E
authors.lastname: Cubo
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
authors.forename: Olivier
authors.initials: O
authors.lastname: Rascol
authors.forename: Laurence
authors.initials: L
authors.lastname: Negre-Pages
authors.forename: Ana
authors.initials: A
authors.lastname: Senard
authors.forename: Johannes
authors.initials: J
authors.lastname: Schwarz
authors.forename: Karl
authors.initials: K
authors.lastname: Strecker
authors.forename: Heinz
authors.initials: H
authors.lastname: Reichmann
authors.forename: Alexander
authors.initials: A
authors.lastname: Storch
authors.forename: Matthias
authors.initials: M
authors.lastname: Löhle
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Stocchi
authors.forename: Katherine
authors.initials: K
authors.lastname: Grosset
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D011307:Drug Prescriptions; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000523:psychology*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D000978:Antiparkinson Agents