Adherence to treatment in Parkinson's disease: A multicenter exploratory study with patients from six Latin American countries |
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| Affiliation: | 1. Movement Disorders Unit, Department of Neurology. Hospital de Clínicas José de San Martín, Buenos Aires, Argentina;2. Movement Disorders and Neurodegenerative Diseases Unit. Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico;3. Movement Disorders and Neuroscience Unit. Hospital Español, Mexico City, Mexico;4. Faculty of Medicine, Pontificia Universidad Católica del Ecuador, Ecuador;5. Movement Disorders Clinic. Centro Médico Nacional de Occidente, Instituto Mexicano Del Seguro Social, Guadalajara, Mexico;6. Hospital Militar Central, Fundación Santa Fe de Bogotá, Colombia;7. Movement Disorders Clinic, Hospital General Regional 1, Instituto Mexicano Del Seguro Social, Mérida, Mexico;8. Parkinson and Movement Disorders Clinic, Department of Neurology, Hospital Universitario Dr. José Eleuterio González. Monterrey, Mexico;9. Department of Neurology, Clínica Las Condes, Santiago, Chile;10. Movement Disorders Clinic, nstituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”. Mexico City, Mexico;11. Hospital Dr. Guillermo Rawson San Juan Argentina, Universidad Católica de Cuyo, Argentina;12. Department of Neurology, Hospital Nacional Daniel A. Carrión, Bellavista, Callao, Peru;1. Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Tübingen, Germany;2. Department of Neurology, Julius-Maximilians-University, Würzburg, Germany;3. Department of Neurology, Christian-Albrechts-University, Kiel, Germany;4. High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany;5. Department of Biomedical Magnetic Resonance, University Hospital Tübingen, Germany;6. Department of General Psychiatry, University of Tübingen, Germany;7. Department of Pediatric Neurology and Developmental Medicine, Children''s Hospital, University of Tübingen, Germany;8. Experimental Pediatric Neuroimaging Group, Pediatric Neurology & Department of Neuroradiology, University Hospital Tübingen, Germany |
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| Abstract: | BackgroundAdherence to treatment in Parkinson's disease (PD) is compromised due to the need for multiple therapies, comorbidities related to aging, and the complexity of therapeutic schemes. In the present study, we aimed to explore adherence to treatment in groups of PD patients from six Latin-American (LA) countries and identify its associated demographic and clinical parameters.MethodsA multicenter, cross-sectional, exploratory study was conducted from September 2016 to March 2017. Treatment adherence was assessed using the simplified medication adherence questionnaire (SMAQ), applied to patients and caregivers. Sociodemographic and clinical variables (MDS-UPDRS Part III-IV, MMSE, Beck Depression Inventory-II (BDI-II)) were recorded.ResultsEight hundred patients from six LA countries were evaluated. Nonadherence was reported in 58.25% of the population, according to patients. The most frequent issues were forgetfulness and correct timing of doses. A high level of agreement in adherence prevalence and most SMAQ items were observed between patients and their caregivers. The nonadherent population had a significantly higher proportion of unemployment, free access to medication, troublesome dyskinesias and off-periods, lesser years of education, and worse motor, cognitive, and mood scores. In multiple logistic and linear regression analyses, MDS-UPDRS Part III, BDI-II, gender, free access to medication, treatment with dopamine agonists alone, years of education, excessive concerns about adverse effects, and beliefs about being well-treated remained significant contributors to adherence measures.ConclusionEducational strategies, greater involvement of PD patients in decision-making, and consideration of their beliefs and values might be of great need to improve medication adherence in this PD population. |
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| Keywords: | Nonadherence Medication Factors Parkinson disease Decision-making |
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