Drugs & Aging

, Volume 26, Issue 2, pp 145–155

Challenges of Treatment Adherence in Older Patients with Parkinson’s Disease

Review Article

DOI: 10.2165/0002512-200926020-00006

Cite this article as:
Bainbridge, J.L. & Ruscin, J.M. Drugs Aging (2009) 26: 145. doi:10.2165/0002512-200926020-00006

Abstract

Patient adherence to a medication regimen is critical to treatment outcome, quality of life and future healthcare costs. For elderly patients with Parkinson’s disease, obstacles to adherence can be particularly complex. Beyond age-related and economic factors, elderly patients with Parkinson’s disease often require complicated dosing or titration schedules and have multiple co-morbidities that necessitate administration of therapies from multiple drug classes. In addition, neuropsychiatric disturbances and cognitive impairment, which are often part of the disease process, can affect adherence, as can variable responses to antiparkinsonian agents as the disease progresses. Several recent studies in patients with Parkinson’s disease point to the need for establishing good adherence patterns early and maintaining these throughout the course of treatment. To achieve optimal adherence in elderly patients with Parkinson’s disease, a combination of pharmacological and non-pharmacological approaches appears to be the best strategy for success. Examples include a strong provider-patient relationship, educational intervention by phone or face-to-face contact, simplified dosing and administration schedules, management and understanding of medication adverse events, and the use of adherence aids such as pill boxes and hour-by-hour organizational charts. Research into new avenues that include improved drug monitoring, pharmacogenetics and neuroprotective regimens may give rise to better adherence in elderly patients with Parkinson’s disease in the future.

Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  1. 1.Department of Clinical PharmacyUniversity of Colorado DenverAuroraUSA
  2. 2.Department of Pharmacy PracticeSouthern Illinois University of EdwardsvilleEdwardsvilleUSA
  3. 3.Department of Clinical Pharmacy, School of Pharmacy C238-L15University of Colorado Denver, Academic Office 1AuroraUSA