Trends in drug use in the PD clinic at the RVH, Edinburgh

By Dr John Cordina, Consultant Geriatrician, Karin Grech Hospital

This audit looked at drug classes and dosing and monitoring among PD patients in 2004 and 2005.

Frequency of drug use:

We have measured a drop in proportion of patients on dopamine agonists (DA) and an increasing preference for non-ergot DA. We observed incomplete baseline tests and monitoring for ergot related side effects. Only 1 patient on DA monotherapy (71 years) and only 1 patient on Apomorphine (63 years).

Almost all patients are on L-DOPA with a diminishing trend in DA use and use of anticholinergics. Patients on DA tend to be younger (70 and 71.2 years) with subtherapeutic dosing regimens for DA employed. 50% of the patients were on ³400 mg of L-DOPA; all patients should be referred to a specialist clinic.

We need to promote the safe use of DA by increasing awareness and education. We can help achieve this by using pro formas, algorithms for use in the clinic, checklists, GP correspondence letter templates, and shared care protocols alongside GPs. We would to re-audit in the future and compare with other clinics.

More Parkinson's Academy Medication Projects

Park in Time
By Dr Geetanjali Khullar, Speciality registrar, St Helens and Knowsley Hospitals NHS Trust
Clozapine in Parkinson's a new model?
By Derek Weidner, lead neurology pharmacist, St George's University Hospitals NHS Foundation Trust
Review of Parkinson’s Disease Medication administration in the in-patient setting
By Dr Anthony O'Sullivan, Geriatric consultant, Whittington Health NHS Trust
'The things you can't get from the books'

Parkinson's Academy, our original and longest running Academy, houses 22 years of inspirational projects, resources, and evidence for improving outcomes for people with Parkinson's. Led by co-founder and educational director Dr Peter Fletcher, the Academy has a truly collegiate feel and prides itself on delivering 'the things you can't get from books' - a practical learning model which inspires all Neurology Academy courses.