Impact of community pharmaceutical care on patient health and quality of drug treatment in Parkinson's disease

Abstract

Background: The well-being of patients with Parkinson's disease may be improved by pharmaceutical care in community pharmacies. Objective: To investigate the effects of standardised pharmaceutical care on health outcomes and quality of drug treatment in patients with Parkinson's disease. Setting: Community pharmacies in Germany. Method: An open-label, multicentre, longitudinal, parallel-group study was conducted in outpatients with idiopathic Parkinson's disease who were receiving antiparkinsonian medication. Patients were recruited by 32 community pharmacists (pharmacy group) and local offices of the German Parkinson's disease patients' association (comparison group). All patients were assessed at baseline and at 8 months' follow-up. In the intervening period, the pharmacists provided patients in the pharmacy group with standardised pharmaceutical care. Main outcome measure: Mean change in symptom-related impairment of health status, assessed using the 23-item Parkinson's Scale Total Score. Results: In total 235 patients were enrolled into the study (113 pharmacy group; 122 comparison group). Between-group analysis showed that the mean changes in the primary and secondary endpoints, all 23-item Parkinson's Scale sub-scores and the EuroQol 5-Dimension Questionnaire Index Score were significantly in favour of the pharmacy group after 8 months (p<0.05 to p<0.001), using a mixed model analysis. No significant changes were observed in prescribers' guideline adherence, but there was a significant decrease in the proportion of patients receiving inappropriate drugs according to the Beers List in the pharmacy group (p<0.01). Conclusion: This study shows that significant benefits in patient health outcomes and age-related quality of drug treatment were gained when patients with Parkinson's disease were provided with standardised pharmaceutical care in community pharmacies. © Springer Science+Business Media B.V. 2012.