PD: Medication Errors, Most Troubling Symptoms (AAN 2004)

Subject: PD: Medication Errors, Most Troubling Symptoms (AAN 2004)

Date: 5/24/2004

E-MOVE reports from the American Academy of Neurology, San Francisco April 25-30, 2004. Page (A), session (S) and poster (P) numbers are from Neurology 2004;62(7), Suppl 5

1. A pilot study of medication errors occurring during the hospitalization of individuals with Parkinson’s disease
A Kraft, S Furtado, R Ranawaya, A Suchowersky
P04.141, A331

Medication errors are common when PD patients are admitted to the hospital, according to this report.

Charts of 10 PD patients admitted to the hospital for non-PD complaints were reviewed. Documented medication errors included abrupt discontinuation (6 patients), the dopamine blockers metoclopramide (4) or haloperidol (2) ordered, inadequate doses of PD drugs (2), levodopa discontinued while entacapone continued (1), and missed doses (1). In only 1 of 10 patients were there no errors made.

The authors state, “These errors reveal a significant lack of understanding of PD and its management by the physicians caring for these patients,” and recommend that patients and families be “vigilant” about medications administered in the hospital.

2. What symptoms are most troubling to patients with Parkinson’s disease?
EA Malecki, CG Vaughan, KE Anderson, PS Fishman, SG Reich, WJ Weiner, LM Shulman
P01.072, A50-51

Ninety-nine PD patients with mean Hoehn & Yahr stage of 2.2 completed a questionnaire regarding which symptoms were the most troubling, which they would target if they could design a drug, and which symptoms are not thought of as part of PD.

Symptoms with a mean rating above 2 (on a scale of 1-3) included loss of balance, trouble speaking, loss of memory and confusion, unpredictable periods when symptoms worsen, slowness or shuffling while walking, loss of fine movement, and tremor. Symptoms chosen by at least 20% of patients to target for treatment included loss of balance (35%), tremor (35%), loss of memory and confusion (26%), and slowness or shuffling (25%). Symptoms not identified as part of PD included urinary problems (62%), “aching, uncontrollable sensations” (60%), anxiety (59%), sexual problems (57%), and constipation (57%).

The authors noted, “Symptoms that threaten independence were identified as the most troubling symptoms…of note, most of these symptoms are poorly responsive to pharmacological agents.”

E-MOVE Editor: Richard Robinson, NASW, WE MOVE

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