Advertisement

Levodopa dosage determines adherence to long-acting dopamine agonists in Parkinson's disease

Published:April 23, 2012DOI:https://doi.org/10.1016/j.jns.2012.03.018

      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Neurological Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Grosset K.A.
        • Bone I.
        • Grosset D.G.
        Suboptimal medication adherence in Parkinson's disease.
        Mov Disord. 2004; 19: 513-517
        • Claxton A.J.
        • Cramer J.
        • Pierce C.
        A systematic review of the associations between dose regimens and medication compliance.
        Clin Ther. 2001; 23: 1296-1310
        • Grosset D.
        • Antonini A.
        • Canesi M.
        • Pezzoli G.
        • Lees A.
        • Shaw K.
        • et al.
        Adherence to antiparkinson medication in a multicenter European study.
        Mov Disord. 2009; 24: 826-832
        • Valldeoriola F.
        • Coronell C.
        • Pont C.
        • Buongiorno M.T.
        • Cámara A.
        • Gaig C.
        • et al.
        Socio-demographic and clinical factors influencing the adherence to treatment in Parkinson's disease: the ADHESON study.
        Eur J Neurol. 2011; 18: 98-987
        • Vitolins M.Z.
        • Rand C.S.
        • Rapp S.R.
        • Ribisl P.M.
        • Sevick M.A.
        Measuring adherence to behavioural and medical interventions.
        Control Clin Trials. 2000; 21: 188S-194S
        • Morisky D.E.
        • Green L.W.
        • Levine D.M.
        Concurrent and predictive validity of a self-reported measure of medication adherence.
        Med Care. 1986; 24: 67-74
        • Daniel S.E.
        • Lees A.J.
        Parkinson's Disease Society Brain Bank, London: overview and research.
        J Neural Transm Suppl. 1993; 39: 165-172
        • Hosmer D.W.
        • Lemeshow S.
        Applied logistic regression.
        John Wiley & Sons, New York1989
        • Davis K.L.
        • Edin H.M.
        • Allen J.K.
        Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data.
        Mov Disord. 2010; 25: 474-480
        • Kulkarni A.S.
        • Balkrishnan R.
        • Anderson R.T.
        • Edin H.M.
        • Kirsch J.
        • Stacy M.A.
        Medication adherence and associated outcomes in medicare health maintenance organization-enrolled older adults with Parkinson's disease.
        Mov Disord. 2008; 23: 359-365
        • Tarrants M.L.
        • Denarié M.F.
        • Castelli-Haley J.
        • Millard J.
        • Zhang D.
        Drug therapies for Parkinson's disease: a database analysis of patient compliance and persistence.
        Am J Geriatr Pharmacother. 2010; 8: 374-383
        • Grosset K.A.
        • Reid J.L.
        • Grosset D.G.
        Medicine-taking behavior: implications of suboptimal compliance in Parkinson's disease.
        Mov Disord. 2005; 20: 1397-1404
        • Burney K.D.
        • Krishnan K.
        • Ruffin M.T.
        • Zhang D.
        • Brenner D.E.
        Adherence to single daily dose of aspirin in a chemoprevention trial. An evaluation of self-reporting and microelectronic monitoring.
        Arch Fam Med. 1996; 5: 297-300
        • Liu H.
        • Golin C.E.
        • Miller L.G.
        • Hayes R.D.
        • Beck C.K.
        • Sanandaji S.
        • et al.
        A comparison study of multiple measures of adherence to HIV protease inhibitors.
        Ann Intern Med. 2001; 134: 968-977
        • Rudd P.
        • Ramesh J.
        • Bryant-Kosling C.
        • Guerrero D.
        Gaps in cardiovascular medication taking.
        J Gen Intern Med. 1993; 8: 659-666
        • Botelho R.J.
        Home assessment of adherence to long-term medication regimen adherence in clinical trials and clinical practice.
        Clin Ther. 1999; 21: 1074-1090
        • Cramer J.A.
        • Mattson R.H.
        • Prevey M.L.
        • Scheyer R.D.
        • Ouellette V.L.
        How often is medication taken as prescribed?.
        JAMA. 1989; 261: 3273-3277
        • Farmer K.C.
        Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice.
        Clin Ther. 1999; 21: 1074-1090
        • Pauler D.K.
        • Gower K.B.
        • Goodman P.J.
        • Crowley J.J.
        • Thompson I.M.
        Biomarker-based methods for determining noncompliance in a prevention trial.
        Control Clin Trials. 2002; 23: 675-685
        • Urquhart J.
        Role of patients compliance in clinical pharmacokinetics. A review of recent research.
        Clin Pharmacokinet. 1994; 27: 202-215
        • Copeland L.G.
        • Dutton J.
        • Roberts N.B.
        • Playfer J.R.
        Routine outpatient l-dopa monitoring in elderly patients with Parkinson's disease.
        Age Ageing. 1994; 23: 138-141
        • Leopold N.A.
        • Polansky M.
        • Hurka M.R.
        Drug adherence in Parkinson's disease.
        Mov Disord. 2004; 19: 513-517
        • Grosset K.A.
        • Bone I.
        • Reid J.L.
        • Grosset D.
        Measuring therapy adherence in Parkinson's disease: a comparison of methods.
        J Neurol Neurosurg Psychiatry. 2006; 77: 249-251
        • Stephenson B.J.
        • Rowe B.H.
        • Haynes R.B.
        • Macharia W.M.
        • Leon G.
        The rational clinical examination. Is this patient taking the treatment as prescribed?.
        JAMA. 1993; 269: 2779-2781
        • Elm J.J.
        • Kamp C.
        • Tilley B.C.
        • Guimaraes P.
        • Fraser D.
        • Deppen P.
        • et al.
        NINDS NET-PD investigators and coordinators. Self-reported adherence versus pill count in Parkinson's disease: the NET-PD experience.
        Mov Disord. 2007; 22: 822-827
        • NINDS NET-PD Investigators
        A randomized, double-blind, futility clinical trial of creatine and minocycline in early Parkinson disease.
        Neurology. 2006; 66: 664-671
        • NINDS NET-PD Investigators
        A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease.
        Neurology. 2007; 68: 20-28
        • Cramer J.A.
        A systematic review of adherence with medications for diabetes.
        Diabetes Care. 2004; 27: 1218-1224
        • Richter A.
        • Anton S.E.
        • Koch P.
        • Dennett S.L.
        The impact of reducing dose frequency on health outcomes.
        Clin Ther. 2003; 25: 2307-2335
        • Schnitzler A.
        • Leffers K.W.
        • Häck H.J.
        High compliance with rotigotine transdermal patch in the treatment of idiopathic Parkinson's disease.
        Parkinsonism Relat Disord. 2010; 16: 513-516