title: Missing dosages and neuroleptic usage may prolong length of stay in hospitalized Parkinson's disease patients.
abstract: BACKGROUND
  Parkinson's disease patients are more likely to be hospitalized, have higher rates of hospital complications, and have an increased risk of deterioration during hospitalization. Length of stay is an important underlying factor for these increased risks. We aimed to investigate potential medication errors that may occur during hospitalization and its impact on length of hospital stay.
  
  
  METHODS
  A cross-sectional chart review of 339 consecutive hospital encounters from 212 PD subjects was performed. Medication errors were defined as wrong timing or omission of administration for dopaminergic drugs and administration of contraindicated dopamine blockers. An analysis of covariance was applied to examine whether these medication errors were related to increased length of hospital stays.
  
  
  RESULTS
  A significant effect for dopaminergic administration (p<0.01) on length of hospital stay was observed. Subjects who had delayed administration or missed at least one dose stayed longer (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4). Contraindicated dopamine blocking agents were administered in 23% (71/339) of cases, and this was also significantly related to an increased length of stay (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4), p<0.05. Participants who received a contraindicated dopamine blocker stayed in the hospital longer (M=7.5 days, SD=9.1) compared to those who did not (M=5.9 days, SD=6.8). Neurologists were consulted in 24.5% of encounters. Specialty consultation had no effect on the medication related errors.
  
  
  CONCLUSIONS
  Missing dopaminergic dosages and administration of dopamine blockers occur frequently in hospitalized Parkinson's disease patients and this may impact length of stay. These potentially modifiable factors may reduce the risk of a longer stay related to hospitalization.
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Daniel
authors.initials: D
authors.lastname: Martinez-Ramirez
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Giugni
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Little
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: John P
authors.initials: JP
authors.lastname: Chapman
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Bilal
authors.initials: B
authors.lastname: Ahmed
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Erin
authors.initials: E
authors.lastname: Monari
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Aparna
authors.initials: A
authors.lastname: Wagle Shukla
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Hess
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America; Department of Neurosurgery, University of Florida College of Medicine, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States of America.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000075202:Contraindications; D003430:Cross-Sectional Studies; D015259:Dopamine Agents / Q000008:administration & dosage*; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D057286:Electronic Health Records; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D055118:Medication Adherence; D008508:Medication Errors; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D014150:Antipsychotic Agents; D015259:Dopamine Agents; D018492:Dopamine Antagonists