title: Carbidopa/levodopa pharmacy errors in Parkinson's disease.
abstract: Outpatient pharmacy errors are common, but little is known about their occurrence in Parkinson's disease (PD). We prospectively studied carbidopa/levodopa pharmacy errors in a cohort of PD outpatients. Over 1 year, pharmacy errors occurred in 8/73 (11%) subjects treated with this medication, producing adverse drug events (ADEs) in 7/8 (87.5%) and increased healthcare utilization in 6/8 (75%) cases. The most common errors were substitution of controlled-release for immediate-release carbidopa/levodopa 25/100 mg (5/8; 62.5%) or dispensation of the wrong carbidopa/levodopa dosage (2/8; 25%). All errors involved ongoing prescriptions, including three interpharmacy transfers. Three subjects (37.5%) questioned pharmacy staff about the change in appearance of the tablets, but the error was corrected in only 1/3 of these cases. Carbidopa/levodopa outpatient pharmacy errors are a common, preventable cause of morbidity and excessive healthcare utilization in PD. Education of healthcare providers, patients, and pharmacy staff is warranted to reduce these errors and associated ADEs.
authors.affiliation: Department of Neurology and Neuroscience, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Nasim R
authors.initials: NR
authors.lastname: Khadem
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Nirenberg
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use*; D002230:Carbidopa / Q000627:therapeutic use*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008508:Medication Errors; D010300:Parkinson Disease / Q000188:drug therapy*; D010594:Pharmacies; D011446:Prospective Studies
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa; D002230:Carbidopa