title: Delayed administration of dopaminergic drugs is not associated with prolonged length of stay of hospitalized patients with Parkinson's disease.
abstract: Punctual delivery of dopaminergic medication to Parkinson's disease (PD) patients may be important in optimizing disease control. We tested the hypothesis that prompt delivery of l-dopa medications to emergency hospital inpatients was associated with a decreased length of stay in hospital.
  
  
  
  The study population consisted of all urgent hospitalizations for patients with a diagnosis of PD to the Royal Derby Hospital over a two-year period. Data were extracted on timing of delivery of drugs, number of co-morbidities and length of stay. Statistical analysis used linear regression adjusting for within admission clustering.
  
  
  
  431 individuals provided data from a total of 737 admissions. 39% of scheduled l-dopa doses were either not given or administered over 30 min later than the scheduled time. There was no association between the omission or timing of a dose of PD medication and length of stay in hospital. The number of coded diagnoses was strongly associated with length of stay with a dose-response association (pTREND<0.001). Those with 10 concurrent diagnoses had a 11 day longer stay (95% confidence intervals: +2 to +21) than those with no comorbidities.
  
  
  
  Delayed administration of dopaminergic drugs is not associated with prolonged length of stay of in patients with PD who were admitted to hospital as an emergency. However, the number of co-existing medical diagnoses was associated with length of stay, and early attention to these has the potential to improve patient care and decrease length of stay in hospital.
authors.affiliation: Department of Medicine for the Elderly, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, United Kingdom. Electronic address: rob.skelly@nhs.net.
authors.forename: Rob
authors.initials: R
authors.lastname: Skelly
authors.affiliation: Department of Neurology, Royal Derby Hospital, Uttoxeter Road, Derby, United Kingdom.
authors.forename: Lisa
authors.initials: L
authors.lastname: Brown
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Fogarty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015259:Dopamine Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D015259:Dopamine Agents; D007980:Levodopa
keywords: Delay; Length of stay; Medication; Parkinson's disease; l-dopa