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In both symptomatic and asymptomatic disease, only about half of medicines are taken as prescribed1. Relatively little is known about how patients with Parkinson's disease take their medication. One of the challenges in the management of Parkinson's disease is the prevention and treatment of involuntary movements2,3 and wild fluctuations between being mobile and able to function against being slow, stiff and unable to move which recurs as a delayed (several years) effect of taking antiparkinson medication. One theory of why this occurs is that it is due to pulsatile rather than continuous delivery of medication to the brain4. If patients take their medicines erratically and irregularly, this causes more fluctuations in blood and therefore brain drug levels may prime patients for complications in the future. This project will define the extent of irregular medication taking in Parkinson's disease, examine associated clinical and demographic characteristics and examine the ease of adherence to different drug regimes. Knowledge of therapy adherence will help support patients in using their medicines to best effect. In the present document the terms compliance and adherence are used with equal meaning.
This is an observational study of how patients with Parkinson's disease take their medication. Antiparkinson medication will be monitored using electronic pill bottles, MEMS, Aardex®, Switzerland (which contain a microprocessor in the cap that records the time and date of bottle openings). This gives information about the amount of prescribed medication taken (total compliance), the percentage of days when the correct number of doses is taken (daily compliance), and the percentage of doses taken at the correct time interval (timing compliance).
Five countries will be involved, (UK, Germany, Italy, Spain and France). The total number of patients recruited across Europe will be 144. The study size has been calculated based on a single centre study in Glasgow where 2/3 of 120 patients were scheduled to undergo electronic monitoring as part of a different study design. Accordingly data is available which has informed the expected number of patients completing the study (around a 10% drop out rate) and in order to test 6 key variables with potential influence on therapy compliance and using the general statistical guide that between 10 and 20 patients should be studied per variable to be examined, a sample size of around 120 evaluable patients has been calculated.
Dr D Grosset
South Glasgow University Hospitals NHS Trust
Published on BioPortfolio: 2014-08-27T03:38:50-0400
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