Background and Importance Pharmacotherapy is the primary treatment for Parkinson Disease (PD). The administration of PD medication needs to be carried out at a particular time to avoid missing doses or inaccurate dosage schemes that may result in motor and non-motor consequences. One-third of all patients with PD visit an emergency department or hospital each year, yet about 70% of neurologists report that PD patients do not get their medication properly when hospitalised. Besides, 1 in 3 patients with PD is prescribed contraindicated drugs during hospitalisation and serious complications, mostly neuropsychiatric, occur in more than half of these patients.
Aim and Objectives To design and implement a medication reconciliation protocol led by clinical pharmacists that allowed to identify, characterise and, eventually, prevent antiparkinsonian medication errors to promote therapeutic quality and safety in daily practice.
Material and Methods This was an interventional, single-centre, one-year, prospective study analysing the impact of developing an antiparkinsonian medication reconciliation programme . All the patients who were hospitalised and had, at least, one active prescription containing an antiparkinsonian drug at hospital admission were included. The medication reconciliation was performed by following a three-phased check: inpatient electronic prescription validation after assessing the outpatient medication schedule, review of the latest clinical report emitted by the Neurology Department, and pharmacist-driven interview of the patient and/or caregiver to confirm the information regarding medication gathered.
Results 171 admission episodes from 132 patients were registered between February 1, 2021, and January 31, 2022. Of 224 prescription lines involving antiparkinsonian drugs, 179 contained, at least, one medication error (59.8%). Commission errors (91.62%) were more frequent than omitted drugs (8.38%). The most common medication errors were related to timing (41.90%), frequency (21.23%), and dosing (19.55%). The implementation of the medication reconciliation programme prevented the erroneous administration of 2716 antiparkinsonian doses, 60% of the total number of doses prescribed during this period. Interestingly, a significant relationship between the number of medication errors and having levodopa prescribed was evidenced (p<0.05). A contraindicated drug was prescribed in almost one-third of the episodes (29.82%).
Conclusion and Relevance Clinical pharmacists' implementation of an antiparkinsonian medication reconciliation programme sharply reduced medication errors, and contraindicated drugs prescription, thus improving therapeutics and drug safety.
Conflict of Interest No conflict of interest
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