Adherence to Antiparkinson Medication in a Multicenter European Study
Identifieur interne : 000F91 ( PascalFrancis/Checkpoint ); précédent : 000F90; suivant : 000F92Adherence to Antiparkinson Medication in a Multicenter European Study
Auteurs : Donald Grosset [Royaume-Uni] ; Angelo Antonini [Italie] ; Margherita Canesi [Italie] ; Gianni Pezzoli [Italie] ; Andrew Lees (neurologue) [Royaume-Uni] ; Karen Shaw [Royaume-Uni] ; Esther Cubo [Espagne] ; Pablo Martinez-Martin [Espagne] ; Olivier Rascol [France] ; Laurence Negre-Pages [France] ; Ana Senard [France] ; Johannes Schwarz [Allemagne] ; Karl Strecker [Allemagne] ; Heinz Reichmann [Allemagne] ; Alexander Storch [Allemagne] ; Matthias Löhle [Allemagne] ; Fabrizio Stocchi [Italie] ; Katherine Grosset [Royaume-Uni]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Two small studies reported suboptimal therapy adherence in Parkinson's disease. We conducted a larger multicenter European study to assess medicine-taking behavior. Parkinson's disease patients taking dopaminergic therapy were enrolled in 8 centers in 5 countries, and disease severity and demographics recorded. Antiparkinson drug adherence was measured for 4 weeks using electronic monitoring bottles which record the date and time of cap opening (Aardex®, Switzerland). One hundred twelve patients, mean age 65 years (standard deviation (SD) 10), with Parkinson's disease for 7.7 (SD 8.2) years completed the study. Total median adherence (doses taken/doses prescribed) was 97.7% (interquartile range [IQ] 90.6-100), days adherence (correct dose days) was 86.2% (IQ 61.1-96.2) and timing adherence (doses taken at correct time intervals) was 24.4% (IQ 5.3-56.5). Fourteen patients (12.5%) took less than 80% of prescribed doses, which was defined as suboptimal adherence. Patients with satisfactory adherence took a median of 8 mg/day (IQ 0-33) less than their prescribed dose of levodopa (P = NS), while suboptimal adherence patients took a median of 481 mg/day (IQ 205-670) less than their prescribed dose (P = 0.0006). The Parkinson motor score was significantly higher in patients with suboptimal adherence at 29 (IQ 20-40), versus those with satisfactory adherence at 19 (IQ 13-26), P = 0.005. Once daily drugs had significantly better adherence when compared with drugs prescribed more frequently (P < 0.0001). Suboptimal therapy adherence is associated with significant deviation from prescribed levodopa doses, despite greater Parkinson's motor severity. Optimizing oral medication intake has a potential role in maximizing the therapy response in Parkinson's disease.
Affiliations:
- Allemagne, Espagne, France, Italie, Royaume-Uni
- Angleterre, Communauté de Madrid, Grand Londres, Latium, Midi-Pyrénées
- Londres, Madrid, Rome, Toulouse
- National Hospital for Neurology and Neurosurgery, Université Toulouse III - Paul Sabatier, Université de Toulouse
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aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>University College London</wicri:noRegion><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName>National Hospital for Neurology and Neurosurgery</orgName></affiliation></author><author><name sortKey="Shaw, Karen" sort="Shaw, Karen" uniqKey="Shaw K" first="Karen" last="Shaw">Karen Shaw</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>University College London</s1><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>University College London</wicri:noRegion></affiliation></author><author><name sortKey="Cubo, Esther" sort="Cubo, Esther" uniqKey="Cubo E" first="Esther" last="Cubo">Esther Cubo</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Carlos III Institute for Health</s1><s2>Madrid</s2><s3>ESP</s3><sZ>7 aut.</sZ><sZ>8 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aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName><placeName><settlement type="city">Toulouse</settlement><region type="region" nuts="2">Midi-Pyrénées</region></placeName><orgName type="university" n="3">Université Toulouse III - Paul Sabatier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Toulouse</orgName></affiliation></author><author><name sortKey="Negre Pages, Laurence" sort="Negre Pages, Laurence" uniqKey="Negre Pages L" first="Laurence" last="Negre-Pages">Laurence Negre-Pages</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Toulouse University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Senard, Ana" sort="Senard, Ana" uniqKey="Senard A" first="Ana" last="Senard">Ana Senard</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Toulouse University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Schwarz, Johannes" sort="Schwarz, Johannes" uniqKey="Schwarz J" first="Johannes" last="Schwarz">Johannes Schwarz</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Leipzig</s1><s3>DEU</s3><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion></affiliation></author><author><name sortKey="Strecker, Karl" sort="Strecker, Karl" uniqKey="Strecker K" first="Karl" last="Strecker">Karl Strecker</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Leipzig</s1><s3>DEU</s3><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion></affiliation></author><author><name sortKey="Reichmann, Heinz" sort="Reichmann, Heinz" uniqKey="Reichmann H" first="Heinz" last="Reichmann">Heinz Reichmann</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Technical University of Dresden</s1><s3>DEU</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Technical University of Dresden</wicri:noRegion><wicri:noRegion>Technical University of Dresden</wicri:noRegion></affiliation></author><author><name sortKey="Storch, Alexander" sort="Storch, Alexander" uniqKey="Storch A" first="Alexander" last="Storch">Alexander Storch</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Technical University of Dresden</s1><s3>DEU</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ><sZ>16 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type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Grosset, Katherine" sort="Grosset, Katherine" uniqKey="Grosset K" first="Katherine" last="Grosset">Katherine Grosset</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Neurological Sciences, Southern General Hospital</s1><s2>Glasgow</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0223199</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0223199 INIST</idno><idno type="RBID">Pascal:09-0223199</idno><idno type="wicri:Area/PascalFrancis/Corpus">000E93</idno><idno type="wicri:Area/PascalFrancis/Curation">001E26</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000F91</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Adherence to Antiparkinson Medication in a Multicenter European Study</title><author><name sortKey="Grosset, Donald" sort="Grosset, Donald" uniqKey="Grosset D" first="Donald" last="Grosset">Donald Grosset</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Neurological Sciences, Southern General Hospital</s1><s2>Glasgow</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Antonini, Angelo" sort="Antonini, Angelo" uniqKey="Antonini A" first="Angelo" last="Antonini">Angelo Antonini</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Parkinson Institute Milan</s1><s3>ITA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Parkinson Institute Milan</wicri:noRegion></affiliation></author><author><name sortKey="Canesi, Margherita" sort="Canesi, Margherita" uniqKey="Canesi M" first="Margherita" last="Canesi">Margherita Canesi</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Parkinson Institute Milan</s1><s3>ITA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Parkinson Institute Milan</wicri:noRegion></affiliation></author><author><name sortKey="Pezzoli, Gianni" sort="Pezzoli, Gianni" uniqKey="Pezzoli G" first="Gianni" last="Pezzoli">Gianni Pezzoli</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Parkinson Institute Milan</s1><s3>ITA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Parkinson Institute Milan</wicri:noRegion></affiliation></author><author><name sortKey="Lees, Andrew" sort="Lees, Andrew" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees (neurologue)</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>University College London</s1><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>University College London</wicri:noRegion><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName>National Hospital for Neurology and Neurosurgery</orgName></affiliation></author><author><name sortKey="Shaw, Karen" sort="Shaw, Karen" uniqKey="Shaw K" first="Karen" last="Shaw">Karen Shaw</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>University College London</s1><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>University College London</wicri:noRegion></affiliation></author><author><name sortKey="Cubo, Esther" sort="Cubo, Esther" uniqKey="Cubo E" first="Esther" last="Cubo">Esther Cubo</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Carlos III Institute for Health</s1><s2>Madrid</s2><s3>ESP</s3><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Martinez Martin, Pablo" sort="Martinez Martin, Pablo" uniqKey="Martinez Martin P" first="Pablo" last="Martinez-Martin">Pablo Martinez-Martin</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Carlos III Institute for Health</s1><s2>Madrid</s2><s3>ESP</s3><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Toulouse University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName><placeName><settlement type="city">Toulouse</settlement><region type="region" nuts="2">Midi-Pyrénées</region></placeName><orgName type="university" n="3">Université Toulouse III - Paul Sabatier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Toulouse</orgName></affiliation></author><author><name sortKey="Negre Pages, Laurence" sort="Negre Pages, Laurence" uniqKey="Negre Pages L" first="Laurence" last="Negre-Pages">Laurence Negre-Pages</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Toulouse University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Senard, Ana" sort="Senard, Ana" uniqKey="Senard A" first="Ana" last="Senard">Ana Senard</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Toulouse University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Schwarz, Johannes" sort="Schwarz, Johannes" uniqKey="Schwarz J" first="Johannes" last="Schwarz">Johannes Schwarz</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Leipzig</s1><s3>DEU</s3><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion></affiliation></author><author><name sortKey="Strecker, Karl" sort="Strecker, Karl" uniqKey="Strecker K" first="Karl" last="Strecker">Karl Strecker</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Leipzig</s1><s3>DEU</s3><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion></affiliation></author><author><name sortKey="Reichmann, Heinz" sort="Reichmann, Heinz" uniqKey="Reichmann H" first="Heinz" last="Reichmann">Heinz Reichmann</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Technical University of Dresden</s1><s3>DEU</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Technical University of Dresden</wicri:noRegion><wicri:noRegion>Technical University of Dresden</wicri:noRegion></affiliation></author><author><name sortKey="Storch, Alexander" sort="Storch, Alexander" uniqKey="Storch A" first="Alexander" last="Storch">Alexander Storch</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Technical University of Dresden</s1><s3>DEU</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Technical University of Dresden</wicri:noRegion><wicri:noRegion>Technical University of Dresden</wicri:noRegion></affiliation></author><author><name sortKey="Lohle, Matthias" sort="Lohle, Matthias" uniqKey="Lohle M" first="Matthias" last="Löhle">Matthias Löhle</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Technical University of Dresden</s1><s3>DEU</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Technical University of Dresden</wicri:noRegion><wicri:noRegion>Technical University of Dresden</wicri:noRegion></affiliation></author><author><name sortKey="Stocchi, Fabrizio" sort="Stocchi, Fabrizio" uniqKey="Stocchi F" first="Fabrizio" last="Stocchi">Fabrizio Stocchi</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>IRCCS San Raffaele Pisana</s1><s2>Rome</s2><s3>ITA</s3><sZ>17 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Grosset, Katherine" sort="Grosset, Katherine" uniqKey="Grosset K" first="Katherine" last="Grosset">Katherine Grosset</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Neurological Sciences, Southern General Hospital</s1><s2>Glasgow</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chemotherapy</term><term>Multicenter study</term><term>Nervous system diseases</term><term>Parkinson disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Chimiothérapie</term><term>Etude multicentrique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Two small studies reported suboptimal therapy adherence in Parkinson's disease. We conducted a larger multicenter European study to assess medicine-taking behavior. Parkinson's disease patients taking dopaminergic therapy were enrolled in 8 centers in 5 countries, and disease severity and demographics recorded. Antiparkinson drug adherence was measured for 4 weeks using electronic monitoring bottles which record the date and time of cap opening (Aardex®, Switzerland). One hundred twelve patients, mean age 65 years (standard deviation (SD) 10), with Parkinson's disease for 7.7 (SD 8.2) years completed the study. Total median adherence (doses taken/doses prescribed) was 97.7% (interquartile range [IQ] 90.6-100), days adherence (correct dose days) was 86.2% (IQ 61.1-96.2) and timing adherence (doses taken at correct time intervals) was 24.4% (IQ 5.3-56.5). Fourteen patients (12.5%) took less than 80% of prescribed doses, which was defined as suboptimal adherence. Patients with satisfactory adherence took a median of 8 mg/day (IQ 0-33) less than their prescribed dose of levodopa (P = NS), while suboptimal adherence patients took a median of 481 mg/day (IQ 205-670) less than their prescribed dose (P = 0.0006). The Parkinson motor score was significantly higher in patients with suboptimal adherence at 29 (IQ 20-40), versus those with satisfactory adherence at 19 (IQ 13-26), P = 0.005. Once daily drugs had significantly better adherence when compared with drugs prescribed more frequently (P < 0.0001). Suboptimal therapy adherence is associated with significant deviation from prescribed levodopa doses, despite greater Parkinson's motor severity. Optimizing oral medication intake has a potential role in maximizing the therapy response in Parkinson's disease.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>24</s2></fA05><fA06><s2>6</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Adherence to Antiparkinson Medication in a Multicenter European Study</s1></fA08><fA11 i1="01" i2="1"><s1>GROSSET (Donald)</s1></fA11><fA11 i1="02" i2="1"><s1>ANTONINI (Angelo)</s1></fA11><fA11 i1="03" i2="1"><s1>CANESI (Margherita)</s1></fA11><fA11 i1="04" i2="1"><s1>PEZZOLI (Gianni)</s1></fA11><fA11 i1="05" i2="1"><s1>LEES (Andrew)</s1></fA11><fA11 i1="06" i2="1"><s1>SHAW (Karen)</s1></fA11><fA11 i1="07" i2="1"><s1>CUBO (Esther)</s1></fA11><fA11 i1="08" i2="1"><s1>MARTINEZ-MARTIN (Pablo)</s1></fA11><fA11 i1="09" i2="1"><s1>RASCOL (Olivier)</s1></fA11><fA11 i1="10" i2="1"><s1>NEGRE-PAGES (Laurence)</s1></fA11><fA11 i1="11" i2="1"><s1>SENARD (Ana)</s1></fA11><fA11 i1="12" i2="1"><s1>SCHWARZ (Johannes)</s1></fA11><fA11 i1="13" i2="1"><s1>STRECKER (Karl)</s1></fA11><fA11 i1="14" i2="1"><s1>REICHMANN (Heinz)</s1></fA11><fA11 i1="15" i2="1"><s1>STORCH (Alexander)</s1></fA11><fA11 i1="16" i2="1"><s1>LÖHLE (Matthias)</s1></fA11><fA11 i1="17" i2="1"><s1>STOCCHI (Fabrizio)</s1></fA11><fA11 i1="18" i2="1"><s1>GROSSET (Katherine)</s1></fA11><fA14 i1="01"><s1>Institute of Neurological Sciences, Southern General Hospital</s1><s2>Glasgow</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>18 aut.</sZ></fA14><fA14 i1="02"><s1>Parkinson Institute Milan</s1><s3>ITA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="03"><s1>University College London</s1><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="04"><s1>Carlos III Institute for Health</s1><s2>Madrid</s2><s3>ESP</s3><sZ>7 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="05"><s1>Toulouse University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></fA14><fA14 i1="06"><s1>University of Leipzig</s1><s3>DEU</s3><sZ>12 aut.</sZ><sZ>13 aut.</sZ></fA14><fA14 i1="07"><s1>Technical University of Dresden</s1><s3>DEU</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></fA14><fA14 i1="08"><s1>IRCCS San Raffaele Pisana</s1><s2>Rome</s2><s3>ITA</s3><sZ>17 aut.</sZ></fA14><fA20><s1>826-832</s1></fA20><fA21><s1>2009</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000186181820050</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>20 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0223199</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Two small studies reported suboptimal therapy adherence in Parkinson's disease. We conducted a larger multicenter European study to assess medicine-taking behavior. Parkinson's disease patients taking dopaminergic therapy were enrolled in 8 centers in 5 countries, and disease severity and demographics recorded. Antiparkinson drug adherence was measured for 4 weeks using electronic monitoring bottles which record the date and time of cap opening (Aardex®, Switzerland). One hundred twelve patients, mean age 65 years (standard deviation (SD) 10), with Parkinson's disease for 7.7 (SD 8.2) years completed the study. Total median adherence (doses taken/doses prescribed) was 97.7% (interquartile range [IQ] 90.6-100), days adherence (correct dose days) was 86.2% (IQ 61.1-96.2) and timing adherence (doses taken at correct time intervals) was 24.4% (IQ 5.3-56.5). Fourteen patients (12.5%) took less than 80% of prescribed doses, which was defined as suboptimal adherence. Patients with satisfactory adherence took a median of 8 mg/day (IQ 0-33) less than their prescribed dose of levodopa (P = NS), while suboptimal adherence patients took a median of 481 mg/day (IQ 205-670) less than their prescribed dose (P = 0.0006). The Parkinson motor score was significantly higher in patients with suboptimal adherence at 29 (IQ 20-40), versus those with satisfactory adherence at 19 (IQ 13-26), P = 0.005. Once daily drugs had significantly better adherence when compared with drugs prescribed more frequently (P < 0.0001). Suboptimal therapy adherence is associated with significant deviation from prescribed levodopa doses, despite greater Parkinson's motor severity. Optimizing oral medication intake has a potential role in maximizing the therapy response in Parkinson's disease.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17F</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Chimiothérapie</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Chemotherapy</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Quimioterapia</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Etude multicentrique</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Multicenter study</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Estudio multicéntrico</s0><s5>10</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Traitement</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Treatment</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Tratamiento</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fN21><s1>166</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Allemagne</li><li>Espagne</li><li>France</li><li>Italie</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Communauté de Madrid</li><li>Grand Londres</li><li>Latium</li><li>Midi-Pyrénées</li></region><settlement><li>Londres</li><li>Madrid</li><li>Rome</li><li>Toulouse</li></settlement><orgName><li>National Hospital for Neurology and Neurosurgery</li><li>Université Toulouse III - Paul Sabatier</li><li>Université de Toulouse</li></orgName></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Grosset, Donald" sort="Grosset, Donald" uniqKey="Grosset D" first="Donald" last="Grosset">Donald Grosset</name></noRegion><name sortKey="Grosset, Katherine" sort="Grosset, Katherine" uniqKey="Grosset K" first="Katherine" last="Grosset">Katherine Grosset</name><name sortKey="Lees, Andrew" sort="Lees, Andrew" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees (neurologue)</name><name sortKey="Shaw, Karen" sort="Shaw, Karen" uniqKey="Shaw K" first="Karen" last="Shaw">Karen Shaw</name></country><country name="Italie"><noRegion><name sortKey="Antonini, Angelo" sort="Antonini, Angelo" uniqKey="Antonini A" first="Angelo" last="Antonini">Angelo Antonini</name></noRegion><name sortKey="Canesi, Margherita" sort="Canesi, Margherita" uniqKey="Canesi M" first="Margherita" last="Canesi">Margherita Canesi</name><name sortKey="Pezzoli, Gianni" sort="Pezzoli, Gianni" uniqKey="Pezzoli G" first="Gianni" last="Pezzoli">Gianni Pezzoli</name><name sortKey="Stocchi, Fabrizio" sort="Stocchi, Fabrizio" uniqKey="Stocchi F" first="Fabrizio" last="Stocchi">Fabrizio Stocchi</name></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Cubo, Esther" sort="Cubo, Esther" uniqKey="Cubo E" first="Esther" last="Cubo">Esther Cubo</name></region><name sortKey="Martinez Martin, Pablo" sort="Martinez Martin, Pablo" uniqKey="Martinez Martin P" first="Pablo" last="Martinez-Martin">Pablo Martinez-Martin</name></country><country name="France"><noRegion><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name></noRegion><name sortKey="Negre Pages, Laurence" sort="Negre Pages, Laurence" uniqKey="Negre Pages L" first="Laurence" last="Negre-Pages">Laurence Negre-Pages</name><name sortKey="Senard, Ana" sort="Senard, Ana" uniqKey="Senard A" first="Ana" last="Senard">Ana Senard</name></country><country name="Allemagne"><noRegion><name sortKey="Schwarz, Johannes" sort="Schwarz, Johannes" uniqKey="Schwarz J" first="Johannes" last="Schwarz">Johannes Schwarz</name></noRegion><name sortKey="Lohle, Matthias" sort="Lohle, Matthias" uniqKey="Lohle M" first="Matthias" last="Löhle">Matthias Löhle</name><name sortKey="Reichmann, Heinz" sort="Reichmann, Heinz" uniqKey="Reichmann H" first="Heinz" last="Reichmann">Heinz Reichmann</name><name sortKey="Storch, Alexander" sort="Storch, Alexander" uniqKey="Storch A" first="Alexander" last="Storch">Alexander Storch</name><name sortKey="Strecker, Karl" sort="Strecker, Karl" uniqKey="Strecker K" first="Karl" last="Strecker">Karl Strecker</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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