Background Use of contraindicated drugs in Parkinson’s disease patients has been associated with an increased risk of extrapyramidal syndrome. Evidence suggests that inappropriate drugs are prescribed in this group of patients in emergency departments. Interventional programmes are needed to prevent this problem.
Purpose To estimate the prevalence of contraindicated drug use in Parkinson’s disease patients in the emergency department.
Material and methods An observational, retrospective study of patients treated with antiparkinsonian drugs who were admitted to hospital from emergency departments (ED) were included between October 2013 and September 2015. Patients were detected in the reconciliation progress in the ED. Each patient admission from the ED in the study period was checked. Treatment data were obtained from the pharmaceutical and medical managing program PCH and the clinical history.
Results 126 patients with Parkinson’s disease who attended the emergency hospital service before admission were evaluated (48% men, mean age 82 ± 1 years). The mean number of admissions per patient was 2.6 ± 1.76. Frequency of Parkinson’s treatment: levodopa/carbidopa 75%, levodopa/benserazide 16%, levodopa/carbidopa/entacapone 6%, levodopa/carbidopa+ levodopa/benserazide 2% and levodopa/carbidopa+levodopa/carbidopa/entacapone 1%. In 44% of them, inappropriate medicines were prescribed: metoclopramide (40.7%), haloperidol (38.9%), both medicines (14.8%) and flunarizine (1.9%), and the regimen of administration was regular in 14 patients (26.9%), pro re nata in 37 patients (71.2%) and both regimens in 1 patient (1.9%). 33 (61%) of these contraindicated drugs were administered to patients: haloperidol (40.6%), metoclopramide (37.5%) and metoclopramide+haloperidol (18.8%).
Conclusion The results showed a high prevalence of metoclopramide and haloperidol use in Parkinson’s disease patients. Inappropriate use of potentially unsafe medicines must be a key issue in medical and pharmaceutical care. Alternatives with no extrapyramidal effects should be considered to minimise the risk in this patient group.
No conflict of interest.
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