Abstract
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.
Highlights
Nonadherence to medication is a common and serious issue in the care of people with Parkinson’s disease (PD)
Grosset et al observed that in 54 PD subjects, all eight domains of Parkinson’s Disease Questionnaire-39 (PDQ-39) correlated with medicine usage, with the association being strongest for social support [4]
We aimed to provide additional data to determine whether self-reported nonadherence is related to health-related quality of life (HRQoL) in PD
Summary
Nonadherence to medication is a common and serious issue in the care of people with Parkinson’s disease (PD). In several cohorts with specific diseases, nonadherence was found to be associated with health-related quality of life (HRQoL) [1,2,3]. This is why QoL can improve following interventions to improve medication adherence [1]. Only a few cross-sectional studies have examined the association between adherence and HRQoL in PD patients. In another study of 124 PD subjects, the 8-Item Morisky Medication Adherence Scale (a common self-report adherence questionnaire) correlated weakly with the PDQ-8 summary index; this significant correlation did not survive correction for other clinical variables in stepwise multiple regression [6]. This limits the generalizability of these data in a disease in which the cumulative incidence of dementia reaches 83% 20 years after diagnosis [7]
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