title: Assessment of appropriate medication administration for hospitalized patients with Parkinson's disease.
abstract: BACKGROUND
  For Parkinson's disease (PD) patients, adherence to a regular PD medication schedule is important in achieving optimal symptom control. There are few published studies quantifying PD medication administrations in hospitalized PD patients.
  
  
  METHODS
  Hospitalization records for 100 veterans with idiopathic PD and admitted to our center were reviewed to determine the on time rate and contraindicated medication doses. A barcode based computerized medication administration system within the electronic medical record provided information of the exact time the medication was given to a patient.
  
  
  RESULTS
  Eighty-nine idiopathic PD patients met study inclusion criteria. Among them, 87 were on levodopa monotherapy or in combination with other PD medications. Two patients were on dopamine agonists only. A total of 3873 doses of PD medications were prescribed during hospitalization. Among 675 incorrect medication administrations, 322 doses were omitted, 300 doses late by ≥ 30 min, and 53 doses given early by ≥ 30 min. Contraindicated medications were prescribed for 19 patients. The correct administration percentage was lower during the first 2 days post-admission compared to subsequent days (mean 74.6% vs. 82.8%) and higher for patients who had neurological consultations (mean 85.5% vs. 76.5%). Correct administration rates were better for patient-based medication schedules (85.6%) than with hospital-based schedules (77.5%), but did not achieve statistical significance.
  
  
  CONCLUSIONS
  Adherence to regular PD medication dosing schedules during hospitalization is problematic, but improves with specialist consultation. Staff involved in the admission process for PD patients should work to safeguard against disruption of the prescribed home dosing schedule.
authors.affiliation: Parkinson's Disease Research, Education and Clinical Center, Department of Neurology, Michael E DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX 77030, USA. jhou@bcm.edu
authors.forename: Jyhgong Gabriel
authors.initials: JG
authors.lastname: Hou
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Wu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Moore
authors.forename: Constance
authors.initials: C
authors.lastname: Ward
authors.forename: Michele
authors.initials: M
authors.lastname: York
authors.forename: Farah
authors.initials: F
authors.lastname: Atassi
authors.forename: Linda
authors.initials: L
authors.lastname: Fincher
authors.forename: Naomi
authors.initials: N
authors.lastname: Nelson
authors.forename: Aliya
authors.initials: A
authors.lastname: Sarwar
authors.forename: Eugene C
authors.initials: EC
authors.lastname: Lai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006787:Hospitals, Veterans; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D016347:Medical Records Systems, Computerized; D055118:Medication Adherence; D008508:Medication Errors; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D010343:Patient Admission; D010593:Pharmaceutical Services / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014728:Veterans
chemical_list: D000977:Antiparasitic Agents; D007980:Levodopa