Aggarwal Shivaansh, Paul Gunchan, Paul Birinder S, Mahendru Diksha, Goyal Shriya
Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Ann Indian Acad Neurol. 2021 Nov-Dec;24(6):879-884. doi: 10.4103/aian.AIAN_143_21. Epub 2021 Aug 20.
The goal of dopaminergic replacement therapy to achieve good clinical outcome in Parkinson's disease (PD) patients largely depends on the pattern of adherence to the pharmacological treatment. This study aims to find the factors affecting medication adherence in patients with PD keeping in mind the cultural, economic, and social diversities so that preventive steps can be taken to fill these gaps.
Demographic data, disease parameters, treatment-related factors, family characteristics, educational, and employment status were assessed for relationship with the medication adherence pattern in a cohort of non-demented PD patients. Medication adherence was measured by MMAS-8; depression, and socioeconomic status were assessed by GDS-SF and Kuppuswamy scales respectively.
From 134 PD subjects, high adherence was observed in 43.2%, 18.2% had moderate, and 38.6% reported low adherence level to their pharmacotherapy. The sub-optimal level of adherence was significantly correlated to compliance of follow up with the physician (p 0.03), presence of adverse events related to drugs (p 0.03), and depressive symptoms (p < 0.0001). Also, there was significant negative co-relationship between poor adherence and depression on Spearman's rank coefficient (0.702). There was no effect of demographic factors, living conditions, family type, educational qualification, associated comorbid conditions, and socioeconomic status on adherence to dopaminergic treatment in patients with PD.
Poor adherence to prescribed medication is a menace that is more than just oversimplification of forgetfulness which should be evaluated at each visit to improve efficacy of the prescribed regimen to achieve better treatment result and thus quality of life of PD patients.
多巴胺能替代疗法在帕金森病（PD）患者中实现良好临床疗效的目标很大程度上取决于药物治疗的依从模式。本研究旨在找出影响PD患者药物依从性的因素，同时考虑文化、经济和社会多样性，以便采取预防措施来填补这些差距。
对一组非痴呆PD患者的人口统计学数据、疾病参数、治疗相关因素、家庭特征、教育和就业状况进行评估，以确定其与药物依从模式的关系。药物依从性通过MMAS-8进行测量；抑郁和社会经济状况分别通过GDS-SF和Kuppuswamy量表进行评估。
在134名PD受试者中，43.2%的人药物依从性高，18.2%的人依从性中等，38.6%的人报告药物治疗依从性低。依从性欠佳与对医生随访的依从性（p = 0.03）、与药物相关的不良事件的存在（p = 0.03）以及抑郁症状（p < 0.0001）显著相关。此外，在Spearman等级系数上，依从性差与抑郁之间存在显著的负相关关系（0.702）。人口统计学因素、生活条件、家庭类型、教育程度、合并症以及社会经济状况对PD患者多巴胺能治疗的依从性没有影响。
对规定药物的依从性差是一种威胁，不仅仅是简单的遗忘，每次就诊时都应进行评估，以提高规定治疗方案的疗效，从而改善PD患者的治疗效果和生活质量。
