Parkinson's medication aids did not improve adherence

SAN DIEGO – The use of pillboxes and other medication management aids by patients with Parkinson’s disease was not associated with increased adherence, results from a single-center study showed.

In fact, those who relied on cell phone alarms actually had worse adherence to their medication. "Medication adherence aids – particularly phone alarms – do not magically improve adherence to medication regimens," Dr. Melissa Armstrong said in an interview after the annual meeting of the American Academy of Neurology, where the study was presented during a poster session.

"I still encourage my patients to use various aids, especially since we don’t have anything better, but I caution them that they shouldn’t think these aids are going to miraculously help them remember to take their doses. It’s still going to take commitment and work. I particularly caution my younger Parkinson’s disease patients using phone alarms that they need to choose good ringtones, be attentive to the reminders, and be careful not to just switch off the phone alarm and proceed on with their day without taking their medications."

In a study conducted at the University of Maryland Parkinson’s disease and movement disorders center in Baltimore, Dr. Armstrong and her associates set out to determine how commonly Parkinson’s patients use medication management aids and to evaluate whether the use of such aids is associated with improved adherence.

"There is little work on this in Parkinson’s disease, despite the complex medication regimens that people with Parkinson’s disease have," said Dr. Armstrong of the department of neurology at the university. "Also, from a clinical perspective, physicians at our movement disorders center realized that we didn’t know how many of our patients were already using different aids to help them remember to take their medications. We thus decided to investigate what our patients are already trying and whether or not the aids are helping."

Patients with Parkinson’s disease for at least 1 year and who were responsible for managing their own medications were eligible for the trial. Referring physicians completed the Unified Parkinsons Disease Rating Scale, and study participants completed the Montreal Cognitive Assessment (MoCA), a medication adherence aid questionnaire, and the 8-item Morisky Medication Adherence Scale (MMAS-8). The mean age of study participants was 69 years, 67% were male, and 93% were white. They were on an average of 2.4 Parkinson’s drugs and an average of 6.9 total drugs.

Of the 104 patients, 78% were adherent to their medications (score of 0-3 on the MMAS-8), and 77 (74%) reported use of one or more aids to manage their medications. These aids were chiefly pillboxes (used by 70 patients, 55 of whom met adherence criteria), followed by 10 who used a cell phone alarm, 7 who used a watch with an alarm, and 6 who used a pillbox with an alarm. Another 27 used no adherence aid.

Overall, Dr. Armstrong and her associates found that 52 (68%) of the 77 patients who used an adherence aid met adherence criteria, the use of adherence aids did not improve medication adherence from a statistical standpoint (P = .58), and the use of a cell phone alarm worsened adherence, with only 5 of 10 users meeting adherence criteria (P less than .05). "This could be because phones are easy to turn off without further response and because mobile phone sounds are so frequent they are not effective," Dr. Armstrong said in the poster. "Future research is needed to investigate the relationship between cell phone alarm use and adherence, especially as their use increases."

Dr. Armstrong acknowledged that the relatively small sample size is a limitation of the study. She said she had no relevant financial disclosures.

dbrunk@frontlinemedcom.com

SAN DIEGO – The use of pillboxes and other medication management aids by patients with Parkinson’s disease was not associated with increased adherence, results from a single-center study showed.

In fact, those who relied on cell phone alarms actually had worse adherence to their medication. "Medication adherence aids – particularly phone alarms – do not magically improve adherence to medication regimens," Dr. Melissa Armstrong said in an interview after the annual meeting of the American Academy of Neurology, where the study was presented during a poster session.

"I still encourage my patients to use various aids, especially since we don’t have anything better, but I caution them that they shouldn’t think these aids are going to miraculously help them remember to take their doses. It’s still going to take commitment and work. I particularly caution my younger Parkinson’s disease patients using phone alarms that they need to choose good ringtones, be attentive to the reminders, and be careful not to just switch off the phone alarm and proceed on with their day without taking their medications."

In a study conducted at the University of Maryland Parkinson’s disease and movement disorders center in Baltimore, Dr. Armstrong and her associates set out to determine how commonly Parkinson’s patients use medication management aids and to evaluate whether the use of such aids is associated with improved adherence.

"There is little work on this in Parkinson’s disease, despite the complex medication regimens that people with Parkinson’s disease have," said Dr. Armstrong of the department of neurology at the university. "Also, from a clinical perspective, physicians at our movement disorders center realized that we didn’t know how many of our patients were already using different aids to help them remember to take their medications. We thus decided to investigate what our patients are already trying and whether or not the aids are helping."

Patients with Parkinson’s disease for at least 1 year and who were responsible for managing their own medications were eligible for the trial. Referring physicians completed the Unified Parkinsons Disease Rating Scale, and study participants completed the Montreal Cognitive Assessment (MoCA), a medication adherence aid questionnaire, and the 8-item Morisky Medication Adherence Scale (MMAS-8). The mean age of study participants was 69 years, 67% were male, and 93% were white. They were on an average of 2.4 Parkinson’s drugs and an average of 6.9 total drugs.

Of the 104 patients, 78% were adherent to their medications (score of 0-3 on the MMAS-8), and 77 (74%) reported use of one or more aids to manage their medications. These aids were chiefly pillboxes (used by 70 patients, 55 of whom met adherence criteria), followed by 10 who used a cell phone alarm, 7 who used a watch with an alarm, and 6 who used a pillbox with an alarm. Another 27 used no adherence aid.

Overall, Dr. Armstrong and her associates found that 52 (68%) of the 77 patients who used an adherence aid met adherence criteria, the use of adherence aids did not improve medication adherence from a statistical standpoint (P = .58), and the use of a cell phone alarm worsened adherence, with only 5 of 10 users meeting adherence criteria (P less than .05). "This could be because phones are easy to turn off without further response and because mobile phone sounds are so frequent they are not effective," Dr. Armstrong said in the poster. "Future research is needed to investigate the relationship between cell phone alarm use and adherence, especially as their use increases."

Dr. Armstrong acknowledged that the relatively small sample size is a limitation of the study. She said she had no relevant financial disclosures.

dbrunk@frontlinemedcom.com

SAN DIEGO – The use of pillboxes and other medication management aids by patients with Parkinson’s disease was not associated with increased adherence, results from a single-center study showed.

In fact, those who relied on cell phone alarms actually had worse adherence to their medication. "Medication adherence aids – particularly phone alarms – do not magically improve adherence to medication regimens," Dr. Melissa Armstrong said in an interview after the annual meeting of the American Academy of Neurology, where the study was presented during a poster session.

"I still encourage my patients to use various aids, especially since we don’t have anything better, but I caution them that they shouldn’t think these aids are going to miraculously help them remember to take their doses. It’s still going to take commitment and work. I particularly caution my younger Parkinson’s disease patients using phone alarms that they need to choose good ringtones, be attentive to the reminders, and be careful not to just switch off the phone alarm and proceed on with their day without taking their medications."

In a study conducted at the University of Maryland Parkinson’s disease and movement disorders center in Baltimore, Dr. Armstrong and her associates set out to determine how commonly Parkinson’s patients use medication management aids and to evaluate whether the use of such aids is associated with improved adherence.

"There is little work on this in Parkinson’s disease, despite the complex medication regimens that people with Parkinson’s disease have," said Dr. Armstrong of the department of neurology at the university. "Also, from a clinical perspective, physicians at our movement disorders center realized that we didn’t know how many of our patients were already using different aids to help them remember to take their medications. We thus decided to investigate what our patients are already trying and whether or not the aids are helping."

Patients with Parkinson’s disease for at least 1 year and who were responsible for managing their own medications were eligible for the trial. Referring physicians completed the Unified Parkinsons Disease Rating Scale, and study participants completed the Montreal Cognitive Assessment (MoCA), a medication adherence aid questionnaire, and the 8-item Morisky Medication Adherence Scale (MMAS-8). The mean age of study participants was 69 years, 67% were male, and 93% were white. They were on an average of 2.4 Parkinson’s drugs and an average of 6.9 total drugs.

Of the 104 patients, 78% were adherent to their medications (score of 0-3 on the MMAS-8), and 77 (74%) reported use of one or more aids to manage their medications. These aids were chiefly pillboxes (used by 70 patients, 55 of whom met adherence criteria), followed by 10 who used a cell phone alarm, 7 who used a watch with an alarm, and 6 who used a pillbox with an alarm. Another 27 used no adherence aid.

Overall, Dr. Armstrong and her associates found that 52 (68%) of the 77 patients who used an adherence aid met adherence criteria, the use of adherence aids did not improve medication adherence from a statistical standpoint (P = .58), and the use of a cell phone alarm worsened adherence, with only 5 of 10 users meeting adherence criteria (P less than .05). "This could be because phones are easy to turn off without further response and because mobile phone sounds are so frequent they are not effective," Dr. Armstrong said in the poster. "Future research is needed to investigate the relationship between cell phone alarm use and adherence, especially as their use increases."

Dr. Armstrong acknowledged that the relatively small sample size is a limitation of the study. She said she had no relevant financial disclosures.

dbrunk@frontlinemedcom.com