18 A Review of Interventions to Improve Medication Adherence in Patients with Parkinson`s Disease (Age and Ageing)

AbstractBackgroundIn Parkinson`s Disease (PD) medication adherence has been neglected. Despite evidence of successful interventions in other chronic diseases, there is currently no review of medication adherence enhancing interventions in PD populations. This review sought to identify and evaluate interventions to improve medication adherence in patients with PD.MethodsSix online databases (PubMed, EMBASE, Medline, PsycINFO, CinahlCOMPLETE, AMED) were searched. Key concepts `Medication adherence` and `Parkinson`s disease` were used. Reference lists of retrieved studies were hand searched. Studies were assessed for inclusion against pre-specified eligibility criteria. Data extraction was carried out using a standardised data extraction table. Critical appraisal was undertaken using the JADAD score, CASP Randomised Controlled Trial (RCT) checklist, `Quality Assessment tool for before-after studies with no control group` and the TREND statement checklist.ResultsThe search resulted in 612 records of which five met inclusion criteria (3 RCT, 2 before-after studies). A total of 496 PD patients were included. Interventional strategies investigated were educational intervention, adherence therapy, effect of a Parkinson`s Tracker App (PTA) and intervention by a pharmacist. Five (100%) of the studies included in this review reported a statistically significant improvement in medication adherence post-intervention and some improvements in symptoms.ConclusionThis is the first review of medication adherence in the PD population. Several different interventions proved effective in enhancing medication adherence, but the studies were small, short term and the risk of bias ranged from moderate to high. Consequently, the results may not be generalisable to other PD populations.