Interventions to improve medication adherence in Parkinson's Disease: a narrative review

Abstract

Introduction: Medication adherence (MA) is sub-optimal in many patients with Parkinson's Disease (PD), which may lead to a lack of medication efficacy, increased symptoms, premature treatment modifications, or poor outcomes. This review analyzes and categorizes interventions designed to improve adherence in PD patients. Methods: Key concepts such as PD and MA were searched in three online databases (MEDLINE, Web of Science, and PsychINFO). There were no exclusions regarding study type or design. To facilitate the interpretation and comparison of the studies, the interventions were classified according to the following categories simplification of the medication regimen, patient/caregiver education, special monitoring, involvement of allied health professionals, intentional MA factors, unintentional MA factors, and combined. Results: Fourteen articles were included for analysis. Of the ten studies that found differences in MA with the intervention, half were combined interventions, and the other half of the studies were categorized as simplification of drug regimen, special monitoring, patient/caregiver education, involvement of allied healthcare professionals, and unintentional MA factors. Conclusion: Improvement in MA in PD patients has been reported for several interventions and intervention categories. However, extrapolation of these results to other PD patient populations is limited by small study samples, short follow-up, and bias.