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Pharmacotherapeutic management of Parkinson’s disease inpatients: how about asking hospital pharmacists?
  1. Unax Lertxundi Etxebarria1,
  2. Itziar Palacios-Zabalza2,3,
  3. Itziar Ibarrondo2,3,
  4. Saioa Domingo-Echaburu4,
  5. Rafael Hernandez5,
  6. Arantxa Isla6,
  7. Marian Solinis6
  1. 1Bioaraba Health Research Institute; Osakidetza Basque Health Service, Araba Mental Health Network, Araba Psychiatric Hospital, Pharmacy Service, Vitoria-Gasteiz, Spain
  2. 2Biocruces Bizkaia Health Research Institute, Pharmacotherapy: Effective, safe and rational use of drugs research group, Osakidetza, Bizkaia, Spain
  3. 3Pharmacy Service, Barrualde Integrated Health Organization, Bizkaia, Spain
  4. 4Pharmacy Service, Alto Deba Integrated Health Organization, Mondragon, Spain
  5. 5Internal Medicine Service, Araba Mental Health Network, Vitoria-Gasteiz, Spain
  6. 6Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de investigación Lascaray ikergunea, University of the Basque Country (UPV/EHU), Paseo de la Universidad, Vitoria-Gasteiz, Spain
  1. Correspondence to Dr Unax Lertxundi Etxebarria, 01006 Vitoria-Gasteiz, Spain; unax.lertxundietxebarria{at}osakidetza.net

Abstract

Introduction Parkinson’s disease (PD) is considered to be the fastest growing neurological disorder in the world. Patients with PD are hospitalised more frequently, have longer admissions and experience more complications during hospitalisation than age-matched control groups. The incorrect timing of levodopa administration and prescription of contraindicated antidopaminergic drugs are the most important risk factors for motor function deterioration during hospital admission, and have been associated with longer hospital stays and even increased mortality. Despite their crucial role in pharmacotherapy, little attention has been paid to the perspective of hospital pharmacists. The objective of this study was to identify key issues in the pharmacotherapeutic management of inpatients with PD by the implementation of a national Spanish survey specifically designed to analyse the perspective of hospital pharmacists.

Methods An internet-based questionnaire covering the following areas was designed: hospital and participant characteristics, drug formulary, medication compliance and reconciliation, protocols and contraindicated drugs and areas for improvement.

Results A total of 76 pharmacists from 59 hospitals answered the survey. Some weaknesses were identified in the availability of drugs: (1) pharmacy services closed at certain times (86.4%); (2) low variety of antiparkinsonian drugs (18.4% store >21 different drugs); (3) delay in antiparkinsonian drug administration if unavailable (>12 hours in 39.5% of cases); (4) lack of flexibility in administration times; (5) low availability of transdermal rotigotine and subcutaneous apomorphine (<50%). The participants ranked highly the designing of specific protocols for patients with PD and implementation of concrete actions to optimise PD inpatient pharmacotherapy.

Conclusions The participants detected some improvement opportunities and proposed realistic and applicable recommendations and strategies aiming to enhance the safety of patients with PD. Protocols for antiparkinsonian drug interchange, administration timing and nil by mouth status, medication reconciliation, and handling nausea/vomiting or psychotic symptoms are considered the main improvement areas.

  • parkinson disease
  • medication systems
  • hospital
  • pharmacy service
  • hospital
  • quality assurance
  • health care
  • education
  • pharmacy

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