Background Parkinson’s disease (PD) is a long-term neurodegenerative disorder, whose onset appears usually after 60 years’ old. Patients often suffer from co-morbidities and have a complex medication regimen. Thus, iatrogenic risk is very high in these patients. In France, there are 25 expert tertiary centres for PD but no data about medication reconciliation (MR) for the patients hospitalised in these centres are currently available.
Purpose To implement the MR process at admission to an expert centre for PD and to assess its impact.
Material and methods The study was conducted prospectively from January 2017 to June 2018. We included all patients over 65 years’ old, admitted in an expert centre for PD in southern France. At admission, we obtained a complete and accurate list of each patient’s current home medications (name, dosage, frequency, route) i.e. the best possible medication history (BPMH). Then we compared the BPMH to the patient’s admission order, identified discrepancies, qualified them as intentional or unintentional with the prescriber, and suggested changes in the prescription, if appropriate. The primary endpoint was to determine the number of patients with at least one unintentional medication discrepancy (UMD). Secondary objectives were to characterise and estimate the severity of potential consequences of UMDs according to Dufay et al 1 and assess the rate of acceptance of suggested modifications.
Results We included 266 patients. Two-hundred and eighty-two UMDs were identified and 114 patients (43%) had at least one UMD. The most frequent UMD was omission of medication (68%). Interestingly, 34% of UMDs affected neurology drugs, including 8% for anti-Parkinson’s drugs. The severity of potential consequences was estimated ‘serious’ in 10% of UMDs. Seventy-six per cent of the modifications suggested were accepted by prescribers.
Conclusion The proportion of patients with at least one UMD, combined with the high rate of acceptance of suggested modifications validated the relevance of MR at admission in an expert centre for PD. Interestingly, a high rate of UMD occurred for neurologic drugs, which may have affected the neurologic assessment.
References and/or acknowledgements 1. Dufay E, et al. Eur J Hosp Pharm2016;23:207–12.
No conflict of interest.