Abstract
Objective
To test whether adherence to non-ergot, once-daily dopamine agonist (ODDA) therapy
depends upon concomitant levodopa daily dose in Parkinson's disease (PD).
Methods
Consecutive levodopa-treated PD patients on ODDA therapy were invited to participate
in the study. ODDA adherence was measured using subjective (Morisky–Green test, MGT)
and objective (electronic monitoring of refill compliance, IANUS) methods. A combination
of MGT and IANUS was used to define full (100%) adherence to ODDA therapy. Logistic
regression methods were used to investigate the impact of levodopa daily dose on ODDA
adherence after adjusting for relevant covariates.
Results
Thirty-nine patients (19 men, 20 women; age, 70.2±8.9 years) were enrolled in the study. Twelve (31%) participants admitted to suboptimal
ODDA compliance. Only 18 (46%) were estimated to be fully compliant. As expected,
adherence was inversely related to levodopa daily dose. For every 100 mg increase in levodopa dose, the risk to failure to adhere increased 1.86 times (95%
CI, 1.21–3.74; p=0.0020). The covariate “total daily number of drugs” (not total daily number of pills)
was also associated with worse adherence (p=0.0061). In contrast, patients who were initially treated with a dopamine agonist
showed better ODDA adherence than those who were initially treated with levodopa (p=0.012). Levodopa doses greater than 600 mg/day were associated with suboptimal compliance.
Conclusions
In levodopa-treated PD patients, adherence to ODDA therapy is suboptimal and strongly
associated with the levodopa daily dose and the total number of drugs used to treat
patients' medical conditions.
Abbreviations:
ODDA (once-daily dopamine agonist), MGT (Morisky–Green test), PD (Parkinson's disease)Keywords
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Article info
Publication history
Published online: April 23, 2012
Accepted:
March 27,
2012
Received in revised form:
March 25,
2012
Received:
February 10,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
