Effect of Pillbox Organizers with Alarms on Adherence to Pharmacotherapy in Parkinson Disease Patients Taking Three and More Daily Doses of Dopaminergic Medications

Abstract

Improvement of adherence to pharmacotherapy in patients with Parkinson’s disease (PD) is a challenge in routine clinical practice. Our study was aimed at the effect of pillbox organizers with alarms improving adherence to pharmacotherapy and its impact on clinical outcomes. Forty nonadherent patients with PD being treated with ≥ 3 daily doses of levodopa and/or dopamine agonists were pseudorandomized and consecutively ranked to groups A (early-start intervention) and B (delayed-start intervention). We used the following validated diagnostic instruments: MMAS-8 (adherence), PDQ-8 (quality of life, QoL), GDS (depression), NMSS (non-motor symptoms), MDS-UPDRS III (motor involvement), MDS-UPDRS IV, and WOQ-9 (motor and non-motor fluctuations and dyskinesias). We proved a significantly improved rate of adherence with the use of pillbox organizers with alarms. Moreover, after only four weeks of using the pillbox organizer, we detected an improvement in QoL scores, motor involvement, motor-, and non-motor fluctuations. Our study showed that pillbox organizers with alarms are efficient in improving adherence to pharmacotherapy in PD. It also could contribute to better motor states, less severe fluctuations, and improved QoL.

Overcoming challenges of clinical cell therapies for Parkinson's disease with photobiomodulation

“…44,45 Hospital and clinical data show that people worldwide have undergone these embryo transplants and that each patient's illness has improved, significantly impacting the disease and their quality of life. 6,7,46 According to reports from these therapeutic trials, positron emission tomography and postmortem evidence may be kept for over 20 years; however, not all patients can get this transplant. 47 However, according to some studies, the maximum time frame for taking these therapies is 10 years, and not all patients can benefit from the advantages of this kind of care.…”

“…The efficiency of employing these factors in producing stem cells could be much higher 44,45 . Hospital and clinical data show that people worldwide have undergone these embryo transplants and that each patient's illness has improved, significantly impacting the disease and their quality of life 6,7,46 . According to reports from these therapeutic trials, positron emission tomography and postmortem evidence may be kept for over 20 years; however, not all patients can get this transplant 47 .…”

Strategies and Tools for Supporting the Appropriateness of Drug Use in Older People

“…They can be filled by physicians, pharmacists, nurses or even by patients themselves or their caregivers [90]. In addition to making medication self-administration easier, these tools can improve unintentional adherence caused by forgetfulness and confusion [91][92][93]. These services are commonly implemented in hospitals and community pharmacies in many countries In an effort to better support patients, families, and caregivers, with new technologies, new dose-dispensing tools (smart pill dispensers) have been developed to help manage complex pharmacotherapies, such as pillboxes with visual and sound alarms that will alert the user to take the medication at the time it must be taken, or other sending email or notifications if a dose is skipped or taken at the wrong time [94].…”