title: Socio-demographic and clinical factors influencing the adherence to treatment in Parkinson's disease: the ADHESON study.
abstract: BACKGROUND
  Symptoms of Parkinson's disease (PD) are usually controlled by a continuous titration of medication and addition of multiple therapies over the course of the disease. Therapeutic complex schemes, polymedication, comorbidities and the number of medications required contribute to non-adherence.
  
  
  METHODS
  This cross-sectional survey was performed in 418 patients with PD on treatment with any antiparkinsonian medication. Patient adherence was assessed through physicians' subjective perception and the Morisky-Green test (MGT). Several social, demographic and clinical features were correlated through bivariate and multivariate analyses.
  
  
  RESULTS
  According to the physician's opinion 93.7%, and according to the MGT 60.4% of patients were adherent to parkinsonian therapy. The bivariate analysis showed greater adherence in patients with a high level of knowledge about the disease (62.8%), good clinical control (63.6%), a spouse or life partner (63%) and higher incomes (66%). Negative correlation with psychiatric symptoms was found. In relation to the MGT, the logistic regression model showed a negative correlation between cognitive deterioration and psychiatric pathology and adherence to therapy.
  
  
  CONCLUSIONS
  The physician's impression overestimated the compliance of patients when compared with an objective evaluation such as the MGT. Cognitive impairment and psychiatric symptoms are the clinical variables associated with a lower level of adherence.
authors.affiliation: Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Valldeoriola
authors.forename: C
authors.initials: C
authors.lastname: Coronell
authors.forename: C
authors.initials: C
authors.lastname: Pont
authors.forename: M T
authors.initials: MT
authors.lastname: Buongiorno
authors.forename: A
authors.initials: A
authors.lastname: Cámara
authors.forename: C
authors.initials: C
authors.lastname: Gaig
authors.forename: Y
authors.initials: Y
authors.lastname: Compta
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D010300:Parkinson Disease / Q000188:drug therapy*; D010820:Physicians; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D000978:Antiparkinson Agents