Parkinson’s Disease Medication Prescribing and Administration During Unplanned Hospital Admissions

2022 ◽  
Author(s):  
Georgia Richard ◽  
Aine Redmond ◽  
Maitreyi Penugonda ◽  
David Bradley
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hospital Admissions ◽  
Medication Prescribing ◽  
Unplanned Hospital Admissions

scholarly journals 285 Inpatient Management of Medications for Parkinson’s Disease

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Kate Doyle ◽  
Agnes Jonsson ◽  
Ciara O'Sullivan ◽  
Paul Gallagher
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Medication Errors ◽  
Hospital Admissions ◽  
Medication Administration ◽  
Loss Of Function ◽  
Inpatient Management ◽  
The Times ◽  
Alternative Routes ◽  
Unplanned Hospital Admissions

Abstract Background Medication errors during unplanned hospital admissions are common in Parkinson’s Disease, often involving late or missed doses. These errors can result in serious complications and loss of function in these patients. Several Parkinson’s Disease networks and associations have run campaigns aiming to improve medication administration in hospital. Methods We reviewed the medical notes and medication charts of 20 patients with Parkinson’s Disease admitted through the Emergency Department. Medication charts were reviewed to assess for levo-dopa containing medications. We assessed whether medication dosing and timing was accurately recorded, if medications were administered on time, and if self-management of medication was considered if the patient was capable during the first 48 hours of admission. We measured our findings against standards from NICE guidelines and Parkinson’s UK. Results Only 9 of 20 cases had the times and doses accurately documented on admission. An average of 2.7 doses/patient were missed or delayed in the 48 hour period. Of 152 total doses, 54 (35%) were missed or late. Only 3 out of 20 patients received all their medications on time. Only one out of 20 patients had a documented order to be allowed to self-manage their medication. Conclusion Medication errors and omissions during unplanned hospital admissions in patients with Parkinson’s Disease are unsurprisingly common. Many doctors are unaware of the need to provide alternative routes of delivering levo-dopa for patients with Parkinson’s Disease who are fasting or unable to swallow. Patients with Parkinson’s Disease are not being empowered to manage their own medication during hospital admission. Educating doctors on the importance of reducing these medication errors, and the existence of the OPTIMAL Calculator to convert the patients’ usual medications to alternative preparations, is imperative to improve inpatient management of patients with Parkinson’s Disease.

scholarly journals Parkinson’s disease hospital admissions in the last decade: a parallel between ages in the Southeast of Brazil

2021 ◽  
Author(s):  
Júlia Estrazulas Falcetta ◽  
Laura Toffoli ◽  
Ana Laura Terra Affonso ◽  
Gabriela Kreutz Ferrari ◽  
Victoria Bento Alves Paglioli ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hospital Admissions ◽  
Epidemiologic Study ◽  
Unknown Origin ◽  
Average Growth ◽  
Age Gap ◽  
Disease Hospital ◽  
Using Data ◽  
Brazilian Health System

Background: Parkinson’s is a neurodegenerative and progressive disease, with an unknown origin that can lead to functional incapacity and decreased quality of life. Objectives: Analyze the number of hospital admissions for Parkinson’s Disease in the Southeast of Brazil. Design and setting: Transversal, descriptive Epidemiologic study between the years of 2011 and 2020 in the Southeast of Brazil. Methods: Study realized using data from the Department of Information of the Brazilian Health System (DATASUS). The variables researched were hospital admissions, age, and year. Results: In the Southeast region, in the determined period, there was an average of 405 hospital admissions per year, an average growth of 4% between the years of 2011 and 2019. However, in 2020, there was a 30% decrease compared to the previous year. It was also observed that in the gap ages between 40 to 49 and 50 to 59 years old, there was a significant increase in the number of hospital admissions. In addition, the age gap between 50 to 80 or more represents an average of 90.88% of all the hospital admissions of the last decade. Conclusion: In the Southeast of Brazil, Parkinson’s Disease had a noticeable absolute reduction of the total admissions analyzed in the last year and a deviation in the average growth of the other years, meaning a possible relation with the COVID-19 pandemic.

The Pattern of Hospital Admissions Prior to Care Home Placement in People With Parkinson’s Disease: Evidence of a Period of Crisis for Patients and Carers

2018 ◽  
Vol 31 (9) ◽  
pp. 1616-1630 ◽  
Author(s):  
Joanna Klaptocz ◽  
William K. Gray ◽  
Sophie Marwood ◽  
Mitali Agarwal ◽  
Joseph Ziegler ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hospital Stay ◽  
Hospital Admissions ◽  
Care Home ◽  
Competing Risk ◽  
Exit Point ◽  
Risk Of Death ◽  
Home Placement ◽  
At Home

Objectives: We hypothesized that the number and length of hospital admissions in people with Parkinson’s disease (PD) would increase immediately prior to admission to a care home relative to those who were able to continue living at home or who died. Method: PD patients at Hoehn and Yahr Stages III to V were followed-up over two and a half years with deaths and care home placements recorded. Hospital admissions data were collected over this period. Results: Of 286 patients included in the study, 7.3% entered a care home and 28.3% died. In the final 120 days prior to the study exit point (care home placement, death, or continued living at home), longer hospital stay was significantly associated with care home placement, after adjusting for the competing risk of death. Conclusion: Our data provide evidence that, for many people with PD, a period of crisis is reached immediately prior to care home placement.

scholarly journals Cardiac Changes in Parkinson’s Disease: Lessons from Clinical and Experimental Evidence

2021 ◽  
Vol 22 (24) ◽  
pp. 13488
Author(s):  
Lorena Cuenca-Bermejo ◽  
Pilar Almela ◽  
Javier Navarro-Zaragoza ◽  
Emiliano Fernández Villalba ◽  
Ana-María González-Cuello ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Side Effect ◽  
Geriatric Patients ◽  
Hospital Admissions ◽  
Negative Inotropic Effect ◽  
Nerve Fibers ◽  
Motor Symptom ◽  
Cardiac Damage

Dysautonomia is a common non-motor symptom in Parkinson’s disease (PD). Most dysautonomic symptoms appear due to alterations in the peripheral nerves of the autonomic nervous system, including both the sympathetic and parasympathetic nervous systems. The degeneration of sympathetic nerve fibers and neurons leads to cardiovascular dysfunction, which is highly prevalent in PD patients. Cardiac alterations such as orthostatic hypotension, heart rate variability, modifications in cardiogram parameters and baroreflex dysfunction can appear in both the early and late stages of PD, worsening as the disease progresses. In PD patients it is generally found that parasympathetic activity is decreased, while sympathetic activity is increased. This situation gives rise to an imbalance of both tonicities which might, in turn, promote a higher risk of cardiac damage through tachycardia and vasoconstriction. Cardiovascular abnormalities can also appear as a side effect of PD treatment: L-DOPA can decrease blood pressure and aggravate orthostatic hypotension as a result of a negative inotropic effect on the heart. This unwanted side effect limits the therapeutic use of L-DOPA in geriatric patients with PD and can contribute to the number of hospital admissions. Therefore, it is essential to define the cardiac features related to PD for the monitorization of the heart condition in parkinsonian individuals. This information can allow the application of intervention strategies to improve the course of the disease and the proposition of new alternatives for its treatment to eliminate or reverse the motor and non-motor symptoms, especially in geriatric patients.

Longitudinal Healthcare Utilization and Costs in Parkinson’s Disease: Pre-Diagnosis to 9 Years After

2021 ◽  
pp. 1-10
Author(s):  
Ming Li Emily Soh ◽  
Xiumin Shermyn Neo ◽  
Seyed Ehsan Saffari ◽  
Sheng Yong Aidan Wong ◽  
Ganga Ganesan ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Movement Disorder ◽  
Healthcare Utilization ◽  
Hospital Admissions ◽  
Emergency Department Visits ◽  
Administrative Databases ◽  
Charlson Comorbidity Index Score ◽  
Term Care

Background: There is currently insufficient long-term data on costs of treatment in patients with Parkinson’s disease (PD), which is chronic and progressive, and associated with substantial healthcare costs. Identifying patterns in healthcare utilization and cost may illuminate further discussion on early intervention. Objective: To characterize long-term healthcare utilization and costs of PD in newly diagnosed patients managed by movement disorder specialists. Methods: Using a longitudinal matched-cohort study of linked data from the National Neuroscience Institute Parkinson’s disease and Movement Disorder and healthcare administrative databases in Singapore from 2008–2017, we compared healthcare utilization and costs between patients and controls matched on age, sex, race, and Charlson Comorbidity Index score. Results: 1,162 patients met study inclusion criteria and 1,157 matched controls were identified. The total mean annual healthcare cost (at 2017 costs) was significantly increased in patients compared to controls from years 1–9 post-diagnosis. The increased cost was observed 2 years before diagnosis (USD2322 vs. 2052; p <  0.001). Mean annual cost attributable to PD increased from USD1854 at 1-year post-diagnosis to USD2652 at 9 years. Over 9 years, average costs were significantly higher across all domains of healthcare utilization except primary care—cost of intermediate and long-term care was increased by a factor of 2.5, specialist care by 2.3, emergency department visits by 1.6, and hospital admissions by 1.3. Conclusion: PD results in higher healthcare utilization and costs. Pre-diagnosis increase in healthcare utilization observed in patients supports the presence of prodromal PD symptoms and may present an opportunity for early diagnosis.

Dysphagia, pneumonia and hospital admissions in Parkinson's Disease: a multicentre observational study

2016 ◽  
Vol 22 ◽  
pp. e47-e48
Author(s):  
Elisavet Moti ◽  
Kristina Lauckaite ◽  
Rui Barreto ◽  
Christina Bitsara ◽  
Miguel Grilo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Study ◽  
Hospital Admissions

The Causes and Impact of Crisis for People with Parkinson’s Disease: A Patient and Carer Perspective

2021 ◽  
pp. 1-11
Author(s):  
Sarah Fearn ◽  
Sandra Bartolomeu Pires ◽  
Veena Agarwal ◽  
Helen C. Roberts ◽  
John Spreadbury ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hospital Admissions ◽  
Health Issues ◽  
Hospital Data ◽  
Care Needs ◽  
Community Based ◽  
Crisis Events ◽  
Personal Experiences ◽  
The Impact

Background: The reasons for acute hospital admissions among people with Parkinson’s disease are well documented. However, understanding of crises that are managed in the community is comparatively lacking. Most existing literature on the causes of crisis for people with Parkinson’s disease (PwP) uses hospital data and excludes the individual’s own perspective on the crisis trigger and the impact of the crisis on their care needs. Objective: To identify the causes and impact of crises in both community and hospital settings, from a patient and carer perspective. Methods: A total of 550 UK-based PwP and carers completed a survey on (a) their own personal experiences of crisis, and (b) their general awareness of potential crisis triggers for PwP. Results: In addition to well-recognised causes of crisis such as falls, events less widely associated with crisis were identified, including difficulties with activities of daily living and carer absence. The less-recognised crisis triggers tended to be managed more frequently in the community. Many of these community-based crises had a greater impact on care needs than the better-known causes of crisis that more frequently required hospital care. PwP and carer responses indicated a good general knowledge of potential crisis triggers. PwP were more aware of mental health issues and carers were more aware of cognitive impairment and issues with medications. Conclusion: These findings could improve care of Parkinson’s by increasing understanding of crisis events from the patient and carer perspective, identifying under-recognised crisis triggers, and informing strategies for best recording symptoms from PwP and carers.

scholarly journals Coding accuracy for Parkinson's disease hospital admissions: implications for healthcare planning in the UK

Public Health ◽  
2017 ◽  
Vol 146 ◽  
pp. 4-9 ◽  
Author(s):  
S. Muzerengi ◽  
C. Rick ◽  
I. Begaj ◽  
N. Ives ◽  
F. Evison ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hospital Admissions ◽  
Healthcare Planning ◽  
Disease Hospital ◽  
The Uk
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