Self-Reported Nonadherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson’s Disease

Feldmann, Francis; Zipprich, Hannah M.; Witte, Otto W.; Prell, Tino

doi:10.1155/2020/4315489

Cited by 8 publications

(10 citation statements)

References 32 publications

(35 reference statements)

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“…As shown in our analyses, patient-related indicators including sociodemographic and personal parameters such as HRQoL, adherence, mood and cognition were not or only poorly associated with changes of medication after discharge, which mirrors the findings by Mansur, Weiss, Hoffman, Gruenewald and Beloosesky [29]. We initially hypothesized that nonadherence could be a predictor of medication change as previously demonstrated for a smaller cohort of people with Parkinson's disease [30]. However, this could not be replicated in this cohort of older adults with mixed disorders.…”

Section: Discussionsupporting

confidence: 88%

Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders

Schwarzkopf

Schönenberg

Prell

2022

JCM

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Background: Medication is often changed after inpatient treatment, which affects the course of the disease, health behavior and adherence. Thus, it is important to understand patterns of medication changes after discharge from hospital. Methods: Inpatients at the Department of Neurology received a comprehensive assessment during their stay, including adherence, depression, cognition, health and sociodemographic variables. A month after being discharged, patients were contacted to enquire about post-discharge medication changes. Results: 910 older adults aged 70 ± 8.6 years participated, of which 204 (22.4%) reported medication changes. The majority of changes were initiated by physicians (n = 112, 56.3%) and only 25 (12.6%) patients reported adjusting medication themselves. Reasons for medication changes differed between patients and doctors (p < 0.001), with side effects or missing effects cited frequently. Sociodemographic and patient-related factors did not significantly predict medication changes. Conclusion: Patients reported less post-discharge medication changes than expected, and contrary to previous literature on nonadherence, only a fraction of those changes were performed by patients themselves. Socioeconomic and clinical parameters regarding personality, mood and cognition were poorly associated with post-discharge medication changes. Instead, individual health-related factors play a role, with patient factors only indirectly influencing physicians’ decisions.

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Section: Discussionsupporting

confidence: 88%

Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders

Schwarzkopf

Schönenberg

Prell

2022

JCM

Self Cite

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“…A considerable proportion of patients change their medication after discharge from a hospital. A third of these patients change their medication on their own due to side effects, missing effect of the medication, missing knowledge about the indication, running out of medication, or nonspecific reason (Feldmann et al 2020 ). The FORTA list can possibly be helpful for choosing a favorable medication and prevent from such medication changes.…”

Section: Discussionmentioning

confidence: 99%

Drug safety profiles in geriatric patients with Parkinson’s disease using the FORTA (Fit fOR The Aged) classification: results from a mono-centric retrospective analysis

et al. 2020

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To reduce potentially inappropriate medications, the FORTA (Fit fOR The Aged) concept classifies drugs in terms of their suitability for geriatric patients with different labels, namely A (indispensable), B (beneficial), C (questionable), and D (avoid). The aims of our study were to assess the medication appropriateness in PD inpatients applying the FORTA list and drug-drug interaction software, further to assess the adequacy of FORTA list for patients with PD. We retrospectively collected demographic data, comorbidities, laboratory values, and the medication from the discharge letters of 123 geriatric inpatients with PD at the university hospital of Hannover Medical School. Patients suffered on average from 8.2 comorbidities. The majority of the medication was labeled A (60.6% of PD-specific and 40.9% of other medication) or B (22.3% of PD-specific and 26.9% of other medication). Administered drugs labeled with D were amantadine, clozapine, oxazepam, lorazepam, amitriptyline, and clonidine. Overall, 545 interactions were identified, thereof 11.9% severe interactions, and 1.7% contraindicated combinations. 81.3% of patients had at least one moderate or severe interaction. The FORTA list gives rational recommendations for PD-specific and other medication, especially for general practitioners. Considering the demographic characteristics and the common multimorbidity of geriatric PD patients, this study underlines the importance of awareness, education, and preventive interventions to increase drug safety.

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“…There is increasing evidence that patients under polypharmacy are often overwhelmed by handling their medication and are not able to maintain an overview without help [ 9 ]. Especially if medication schemes were modified in an inpatient setting, the patients often did not know about their new medication in follow-up investigations [ 10 , 11 ]. Adding to this, general practitioners regularly change medication schemes shortly after discharge from the hospital [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Patient Safety in a Box: Implementation and Evaluation of the Emergency Box in Geriatric and Parkinson Patients

Krey

Lange

Tran

et al. 2021

JCM

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In an industrial society, the proportion of geriatric people increases with rising age. These people are likely to use polypharmacy and experience medical emergencies. However, their emergency care can be complicated by unclear comorbidities and medication. The aim of this prospective interventional study was to assess the demand for a drug safety tool in clinical practice and to analyze whether the emergency box can improve acute care in a geriatric cohort. Therefore, emergency room (ER) doctors in a German tertiary hospital recorded the number of geriatric patients lacking medical information and its impact on diagnostics/treatment. Furthermore, the emergency box was distributed to patients on the neurological ward and their current drug safety concepts were assessed. After 6 months, we evaluated in a follow-up whether the tool was helpful in emergency cases. Our study revealed that 27.4% (n = 28) of the patients came to the ER without their medical information, which caused a relevant delay or possible severe complications in 11.8% (n = 12). The emergency box was perceived as easily manageable and 87.9% (n = 109) of the participants wanted to keep it after the study. Subjectively, participants benefitted in emergencies. In conclusion, the emergency box is a cheap tool that is easy to use. It can save valuable time in emergencies and increases the safety of geriatric patients.

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Self-Reported Nonadherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson’s Disease

Cited by 8 publications

References 32 publications

Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders

Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders

Drug safety profiles in geriatric patients with Parkinson’s disease using the FORTA (Fit fOR The Aged) classification: results from a mono-centric retrospective analysis

Patient Safety in a Box: Implementation and Evaluation of the Emergency Box in Geriatric and Parkinson Patients

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