Socio-demographic and clinical factors influencing the adherence to treatment in Parkinson's disease: the ADHESON study

Eur J Neurol. 2011 Jul;18(7):980-7. doi: 10.1111/j.1468-1331.2010.03320.x. Epub 2010 Dec 29.

Abstract

Background: Symptoms of Parkinson's disease (PD) are usually controlled by a continuous titration of medication and addition of multiple therapies over the course of the disease. Therapeutic complex schemes, polymedication, comorbidities and the number of medications required contribute to non-adherence.

Methods: This cross-sectional survey was performed in 418 patients with PD on treatment with any antiparkinsonian medication. Patient adherence was assessed through physicians' subjective perception and the Morisky-Green test (MGT). Several social, demographic and clinical features were correlated through bivariate and multivariate analyses.

Results: According to the physician's opinion 93.7%, and according to the MGT 60.4% of patients were adherent to parkinsonian therapy. The bivariate analysis showed greater adherence in patients with a high level of knowledge about the disease (62.8%), good clinical control (63.6%), a spouse or life partner (63%) and higher incomes (66%). Negative correlation with psychiatric symptoms was found. In relation to the MGT, the logistic regression model showed a negative correlation between cognitive deterioration and psychiatric pathology and adherence to therapy.

Conclusions: The physician's impression overestimated the compliance of patients when compared with an objective evaluation such as the MGT. Cognitive impairment and psychiatric symptoms are the clinical variables associated with a lower level of adherence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / therapeutic use*
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Parkinson Disease / drug therapy*
  • Physicians
  • Socioeconomic Factors
  • Surveys and Questionnaires

Substances

  • Antiparkinson Agents