What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

Mendorf, Sarah; Witte, Otto W.; Großkreutz, Julian; Zipprich, Hannah M.; Prell, Tino

doi:10.3389/fmed.2020.00103

Cited by 16 publications

(35 citation statements)

References 37 publications

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“…In line with earlier studies in PD, our multivariable analyses confirmed that depression, poor motor function (MDS-UPDRS III), lower education level, and higher LEDD are associated with nonadherence to medication (3,4,17). With reference to the study by Straka et al, we confirmed that the overall burden of NMS (NMSQ total score) is associated with nonadherence.…”

Section: Discussionsupporting

confidence: 91%

“…Many reasons exist why people with PD do not or cannot follow instructions given for prescribed medical treatments. Several epidemiological and clinical factors were found to be associated with nonadherence to medication in PD, such as younger age, education level, marital status, depression and anxiety, poor cognition, longer disease duration, and regimen complexity (3,4,6,(10)(11)(12)(13)(14)(15)(16)(17). Recently, Straka et al studied the relationship between NMS and adherence in 124 subjects with PD recruited from movement disorder outpatient departments of university hospitals in Slovakia (18).…”

Section: Introductionmentioning

confidence: 99%

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Association Between Nonmotor Symptoms and Nonadherence to Medication in Parkinson's Disease

et al. 2020

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Background: Nonadherence to medication is a common and serious issue in the treatment of patients with Parkinson's disease (PD). Among others, distinct nonmotor symptoms (NMS) were found to be associated with nonadherence in PD. Here, we aimed to confirm the association between NMS and adherence. Methods: In this observational study, the following data were collected: sociodemographic data, the German versions of the Movement Disorder Society-sponsored revision of the unified Parkinson's disease rating scale for motor function (MDS-UPDRS III), Hoehn and Yahr (H&Y) stage, levodopa equivalent daily dose (LEDD), Becks depression inventory II (BDI-II), nonmotor symptoms questionnaire (NMSQ), and the Stendal adherence to medication score (SAMS). Results: The final sample included 137 people with PD [54 (39.4%) females] with a mean age of 71.3 ± 8.2 years. According to SAMS, 10.9% of the patients were fully adherent, 73% were moderately nonadherent, and 16.1% showed clinically significant nonadherence. Nonadherence was associated with LEDD, BDI-II, education level, MDS-UPDRS III, and the NMSQ. The number of NMS was higher in nonadherent patients than in adherent patients. In the multiple stepwise regression analysis, the items 5 (constipation), 17 (anxiety), and 21 (falls) predicted nonadherence to medication. These NMSQ items also remained significant predictors for SAMS after correction for LEDD, MDS-UPDRS III, BDI-II, age, education level, gender, and disease duration. Conclusion: Our study, in principle, confirms the association between NMS burden and nonadherence in PD. However, in contrast to other clinical factors, the relevance of NMSQ in terms of nonadherence is low. More studies with larger sample sizes are necessary to explore the impact of distinct NMS on adherence.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Association Between Nonmotor Symptoms and Nonadherence to Medication in Parkinson's Disease

et al. 2020

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“…The low MoCA in our patients is due to the fact that some of the patients could not complete formal items of the MoCA, for example, because of visual or motor problems. In our previous study, we observed no association between self-reported adherence and cognition in people with PD [ 23 ].…”

Section: Discussionmentioning

confidence: 83%

Self-Reported Nonadherence to Medication Is Not Associated with Health-Related Quality of Life in Parkinson’s Disease

2021

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Nonadherence is a growing issue in the treatment of Parkinson’s disease (PD). Many factors are known to influence nonadherence, but little is known about the influence of quality of life (QoL). Detailed clinical data were obtained from 164 patients with PD using the Parkinson’s Disease Questionnaire-39 (PDQ-39) and the German Stendal Adherence with Medication Score (SAMS). Descriptive statistics were used to identify reasons for nonadherence, and multivariable linear models were used to study associations between QoL and clinical parameters as well as nonadherence. Multivariate analysis of variance (MANOVA) and multivariate analysis of covariance (MANCOVA) were used to study the effect of the SAMS on PDQ domains and other medical covariates. The results showed that 10.4% (n = 17) of patients were fully adherent, 66.4% (n = 109) were moderately nonadherent, and 23.2% (n = 38) were nonadherent. Nonadherence was associated with male gender, lower Montreal Cognitive Assessment (MoCA) score, higher non-motor symptoms questionnaire (NMS-Quest) score, greater number of medications per day (an indicator of comorbidity), and higher Beck Depression Inventory (BDI) score. QoL was correlated with male gender, lower MoCA score, higher NMS-Quest score, more comorbidities, and higher BDI score, but was not correlated with nonadherence.

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“…Nonadherence to medication is a significant issue in PD. It results in frequent hospitalizations, reduced quality of life, and causes a financial burden for the health system [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. There are various reasons why people do not or cannot follow the given recommendations and instructions for the prescribed treatment.…”

Section: Field Of Activities and Responsibilitiesmentioning

confidence: 99%

Specialized Staff for the Care of People with Parkinson’s Disease in Germany: An Overview

Prell

Siebecker

Lorrain

et al. 2020

JCM

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Access to specialized care is essential for people with Parkinson´s disease (PD). Given the growing number of people with PD and the lack of general practitioners and neurologists, particularly in rural areas in Germany, specialized PD staff (PDS), such as PD nurse specialists and Parkinson Assistants (PASS), will play an increasingly important role in the care of people with PD over the coming years. PDS have several tasks, such as having a role as an educator or adviser for other health professionals or an advocate for people with PD to represent and justify their needs. PD nurse specialists have been established for a long time in the Netherlands, England, the USA, and Scandinavia. In contrast, in Germany, distinct PDS models and projects have been established. However, these projects and models show substantial heterogeneity in terms of access requirements, education, theoretical and practical skills, principal workplace (inpatient vs. outpatient), and reimbursement. This review provides an overview of the existing forms and regional models for PDS in Germany. PDS reimbursement concepts must be established that will foster an implementation throughout Germany. Additionally, development of professional roles in nursing and more specialized care in Germany is needed.

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What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

Cited by 16 publications

References 37 publications

Association Between Nonmotor Symptoms and Nonadherence to Medication in Parkinson's Disease

Association Between Nonmotor Symptoms and Nonadherence to Medication in Parkinson's Disease

Self-Reported Nonadherence to Medication Is Not Associated with Health-Related Quality of Life in Parkinson’s Disease

Specialized Staff for the Care of People with Parkinson’s Disease in Germany: An Overview

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