Two centuries have passed since the term ‘Parkinson’s disease’ (PD) was first coined; however, we do not yet have any treatments that can cure, slow, stop or reverse progression of the condition, and scientists are still unsure as to why people get PD in the first place.
As a result, managing the symptoms of PD is a crucial element of the care that healthcare professionals can provide to these patients, and this often involves medicines.
Levodopa — a drug discovered in the 1970s that compensates for the loss of dopamine-producing neurons — remains the most successful drug to be developed for the condition despite the fact that it becomes less effective over time.
However, each patient’s experience of PD is different, so they may need to try a number of different drugs, doses and therapies to find out which works best for them. This is where pharmacists can make a real difference.
Undoubtedly, pharmacists are well placed to manage the complex medication regimens of PD patients by not only addressing a raft of motor and non-motor symptoms but also managing other co-morbidities, such as diabetes or hypertension.
In a letter to
, Stephanie Bancroft from the London North West Local Practice Forum described the outcome of a PD-specific medicines use review pilot across eight pharmacies in the area
. Patients were said to welcome the opportunity to provide feedback and be able to talk to a pharmacist about their concerns and problems, in particular regarding problems with non-motor symptoms and a lack of understanding around their medicines and how they work.
Managing the symptoms of PD while limiting the incidence of unpleasant side effects presents a challenge to healthcare professionals. In its guidance for pharmacists, Parkinson’s UK emphasises that if not enough attention is paid to Parkinson’s medication, symptoms can become poorly controlled and the patient’s condition can, very quickly, deteriorate.
The importance of medicines management in PD means that pharmacists are an essential resource that should not be undervalued.
Pharmacists in community and hospital settings can support patients to adhere to their prescribed medicines, help them to understand possible side effects, make sure other medicines do not exacerbate PD, support people with hospital admissions and, most importantly, help people take control of their condition, particularly if they have been in hospital.
In July 2017, the National Institute for Health and Care Excellence (NICE) released new guidance on PD, the first update since 2006. One key change was to recommend the use of levodopa as a first-line treatment for patients whose motor symptoms start to interfere with their quality of life.
All pharmacists should find out more about PD and equip themselves as best as possible to support patients with this condition while scientists inch closer to a cure.
 Stephanie Bancroft. Parkinson’s disease-specific medicines use review. Clinical Pharmacist 2017;9(1):11