What is known about the challenges people with Parkinson's disease experience with their medicines and what solutions have been explored to overcome them? A scoping review.

Abstract

The symptomatic management of Parkinson's disease (PD) relies heavily on medications, which increase in complexity as the disease progresses. To describe (i) the extent, range, and nature of research describing the experience and challenges people with PD and their carers have with their medicines for symptomatic treatment, and (ii) any interventions that have been reported in a community setting that address medicine-related challenges experienced by people with PD. The scoping review searched electronic databases (EMBASE, PubMed, and CINAHL). The studies included were full-text articles in English only, including conference abstracts that focussed on patients with PD or their carers and discussed medicines in the primary care setting, even where this was not the primary focus. Thirty-nine papers were taken forward for data extraction. Twenty described patient experience and challenges. Although none were explicitly focussed on medications, they did highlight challenges including the work of taking multiple medications and a desire for non-oral formulations. Nineteen described or tested interventions to support people with PD with their medication including community pharmacist-led reviews, medication compliance aids, and the use of text message reminders. These were all small-scale feasibility and pilot studies, and none were grounded in a methodological framework. Positive outcomes were reported against various scales, but no evidence of scaling up any of the interventions was found. There is very little published research surrounding the challenges people with PD have with their medicines. The published research that does exist alludes to challenges with medicines taking in people with PD but identifies a gap in the detail and understanding. Further work is required to improve our understanding and allow the development of sustainable interventions that support people with PD and their carers.