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5PSQ-003 Improving medicines management of inpatient Parkinson’s disease patients by making pharmacy interventions
  1. M Knipe1,
  2. E Conyard1,
  3. M Donovan2
  1. 1Our Lady of Lourdes Hospital, Pharmacy Department, Drogheda, Ireland Rep
  2. 2University College Cork, School of Pharmacy, Cork, Ireland Rep


Background and Importance Hospital admissions of Parkinson’s disease (PD) patients can result in medication regimen disruptions causing adverse effects for PD patients. Evidence shows that interventions can reduce medication-errors and administration of contraindicated medicines in PD patients.

Aim and Objectives The study aim was to quantify the impact of a pharmacist’s involvement in optimising medicines management of inpatient PD patients.

Material and Methods A 2-month ‘baseline’ audit was completed prior to intervention implementation and measured patient demographics, delay in first dose following admission, medication errors (missed/delayed doses), pharmacist medicines reviews and time until completion and patient outcome (prevalence of falls, delirium, rigidity). The outcome of patients who were ‘nil by mouth’ was also assessed. Three interventions were implemented over a 1-month period. These were priority pharmacist medicines reviews of PD patients, PD medication ward stock optimisation and doctor/nurse PD medicine management education sessions. A post-intervention audit identical to the ‘baseline’ audit was completed and both audits were compared.

Results The ‘baseline’ audit (mean age 81, 24 patients, 1,611 due doses) and the post-intervention audit (mean age 80, 30 patients, 1,840 due doses) were analysed. Medicine reviews increased from 79% to 97% (p=0.042) and these were completed 38.7 hours (p<0.001) sooner post-admission. A reduction in first dose delay was seen (13.5 vs 4.4 hours (p<0.001)), along with reductions in delayed (5% to 1% (p=0.037)) and missed doses (8% to 2% (p<0.001)). Omitted pre-admission PD medications reduced from 16% to 2% (p=0.011). Staff education contributed to recorded due times increasing from 44% to 97% (p<0.001). Contraindicated medicines were administered at reduced rates in the post-intervention audit. The length of admission was shorter due to the combination of interventions (19 vs 15 days (p=0.475)). These improvements resulted in a reduced prevalence of falls (25% to 17%), delirium episodes (29% to 7%) and rigidity (54% to 7%). Patients were more able to interact with allied health professionals in the post-intervention audit (46% vs 100%). Improvements in non-oral PD medicines prescribing occurred in ‘nil by mouth’ patients.

Conclusion and Relevance This study showed the introduction of the pharmacist-led interventions can improve PD inpatient outcomes, by reducing medication errors, decreasing the administration of contraindicated medicines and preventing delays in the administration of PD drugs.

Conflict of Interest No conflict of interest.

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