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Purpose: This study aimed to determine how limited medication knowledge as one aspect of health literacy contributes to poorer health-related quality of life (HRQoL) in people with Parkinson's disease (PD). Methods: Demographical data, PD-specific data (MDS-Unified Parkinson's Disease-Rating Scale, Nonmotor symptom scale), and data about depressive symptoms (Beck's depression inventory), cognition (Montreal cognitive assessment), HRQoL (Short-Form Health Questionnaire-36, SF-36), and medication knowledge (names, time of taking, indication, dosage) were assessed in 193 patients with PD. Multivariate analysis of variance (MANOVA), multivariate analysis of covariance, and mediation analyses were used to study the relationship between medication knowledge and HRQoL in combination with different mediators and covariates. Results: Overall, 43.5% patients showed deficits in at least one of the 4 knowledge items, which was associated with higher age, number of medications per day and depression level, and poorer cognitive function, motor function, and lower education level. Using one-way MANOVA, we identified that medication knowledge significantly impacts physical functioning, social functioning, role limitations due to physical problems, and role limitations due to emotional problems. Mediation models using age, education level, and gender as covariates showed that the relationship between knowledge and SF-36 domains was fully mediated by Beck's Depression Inventory but not by Montreal Cognitive Assessment. Conclusions: Patients who expressed unawareness of their medication did not necessarily have cognitive deficits; however, depressive symptoms may instead be present. This concomitant depressive symptomatology is crucial in explaining the contribution of nonadherence and decreased medication knowledge to poor quality of life. [ABSTRACT FROM AUTHOR]

Background: Detailed knowledge about nonadherence to medication could improve medical care in elderly patients. We aimed to explore patterns and reasons for nonadherence in people with Parkinson's disease (PD) aged 60 years and older.Methods: Detailed clinical data and adherence (German Stendal Adherence with Medication Score) were assessed in 230 patients with PD (without dementia). Descriptive statistics were used to study reasons for nonadherence in detail, and general linear models were used to study associations between clusters of nonadherence and clinical parameters.Results: Overall, 14.2% (n = 32) of the patients were fully adherent, 66.8% (n = 151) were moderately nonadherent, and 19.0% (n = 43) showed clinically meaningful nonadherence. In the multivariable analysis, nonadherence was associated with a lower education level, higher motor impairment in activities of daily living, higher number of medications per day, and motor complications of PD. Three clusters of nonadherence were observed: 59 (30.4%) patients reported intentional nonadherence by medication modification; in 72 (37.1%) patients, nonadherence was associated with forgetting to take medication; and 63 (32.5%) patients had poor knowledge about the prescribed medication. A lower education level was mainly associated with modification of medication and poorer knowledge about prescribed medication, but not with forgetting to take medication. Patients with motor complications, which frequently occur in those with advanced disease stages, tend to be intentionally nonadherent by modifying their prescribed medication. Increased motor problems and a higher total number of drugs per day were associated with less knowledge about the names, reasons, and dosages of their prescribed medication.Conclusions: Elderly patients with PD report many reasons for intentional and non-intentional nonadherence. Understanding the impact of clinical parameters on different patterns of nonadherence may facilitate tailoring of interventions and counseling to improve outcomes.

Nonadherence is a growing issue in the treatment of Parkinson’s disease (PD). Many factors are known to influence nonadherence, but little is known about the influence of quality of life (QoL). Detailed clinical data were obtained from 164 patients with PD using the Parkinson’s Disease Questionnaire-39 (PDQ-39) and the German Stendal Adherence with Medication Score (SAMS). Descriptive statistics were used to identify reasons for nonadherence, and multivariable linear models were used to study associations between QoL and clinical parameters as well as nonadherence. Multivariate analysis of variance (MANOVA) and multivariate analysis of covariance (MANCOVA) were used to study the effect of the SAMS on PDQ domains and other medical covariates. The results showed that 10.4% (n = 17) of patients were fully adherent, 66.4% (n = 109) were moderately nonadherent, and 23.2% (n = 38) were nonadherent. Nonadherence was associated with male gender, lower Montreal Cognitive Assessment (MoCA) score, higher non-motor symptoms questionnaire (NMS-Quest) score, greater number of medications per day (an indicator of comorbidity), and higher Beck Depression Inventory (BDI) score. QoL was correlated with male gender, lower MoCA score, higher NMS-Quest score, more comorbidities, and higher BDI score, but was not correlated with nonadherence.

Nonadherence is a growing issue in the treatment of Parkinson's disease (PD). Many factors are known to influence nonadherence, but little is known about the influence of quality of life (QoL). Detailed clinical data were obtained from 164 patients with PD using the Parkinson's Disease Questionnaire-39 (PDQ-39) and the German Stendal Adherence with Medication Score (SAMS). Descriptive statistics were used to identify reasons for nonadherence, and multivariable linear models were used to study associations between QoL and clinical parameters as well as nonadherence. Multivariate analysis of variance (MANOVA) and multivariate analysis of covariance (MANCOVA) were used to study the effect of the SAMS on PDQ domains and other medical covariates. The results showed that 10.4% (n = 17) of patients were fully adherent, 66.4% (n = 109) were moderately nonadherent, and 23.2% (n = 38) were nonadherent. Nonadherence was associated with male gender, lower Montreal Cognitive Assessment (MoCA) score, higher non-motor symptoms questionnaire (NMS-Quest) score, greater number of medications per day (an indicator of comorbidity), and higher Beck Depression Inventory (BDI) score. QoL was correlated with male gender, lower MoCA score, higher NMS-Quest score, more comorbidities, and higher BDI score, but was not correlated with nonadherence. [ABSTRACT FROM AUTHOR]