Right Time, Right Dose: Improving Parkinson’s Disease Medication Prescribing on Geriatric Wards- QIP

Introduction

Parkinson’s disease (PD) affects approximately 145,000 individuals in the United Kingdom, and its prevalence is projected to increase by 20% by 2025.Parkinson disease medications are time-critical, and delays in prescribing or administration can lead to worse clinical outcomes. This Quality Improvement Project (QIP) was undertaken to evaluate the accuracy of Parkinson’s disease (PD) medication prescriptions on admission to the University Hospital Lewisham (UHL) Elderly Care Wards

Method

A retrospective review of patient records and pharmacy medication histories was conducted using predefined inclusion and exclusion criteria. Data variables included drug name, strength, formulation, frequency, administration times, and prescription changes. Interventions included staff education sessions, awareness of intranet guidance, early pharmacy involvement, and implementation of a local PD alert card. Post-intervention data were collected and compared with baseline to assess improvement.

Results

Baseline data from 27 patients showed that 19 patients missed their scheduled next dose of Parkinson’s disease (PD) medication at the time of admission.4 patients were prescribed medication at the wrong frequency, 1 at the wrong strength, 1 with an incorrect formulation, 2 with wrong doses, and 2 had missing medications.

Post-intervention data from 28 patients demonstrated marked improvement, with only 6 patients missing their first dose compared to 19 at baseline.1 patient was prescribed medication at the wrong frequency, none at the wrong strength or formulation, 1 at the wrong dose, and none had missing medications.

Conclusion

The implementation of targeted interventions led to a 68% reduction in missed Parkinson’s disease medication doses and significant improvement in prescription accuracy on admission. These interventions enhanced patient safety and promoted timely administration of time-critical medications. Further work is needed for the implementation of the PD Alert Card within Parkinson’s services and to promote its universal adoption across the NHS to ensure consistent, safe, and timely management of PD medications.