Background. Medication is often changed after hospital discharge in people with Parkinson’s disease (PD). Objective. This observational study aimed to describe changes in PD medication after discharge and explore their association with self-reported adherence and clinical parameters. Methods. During hospitalisation sociodemographic characteristics, the Movement Disorder Society-sponsored revision of the Unified PD Rating Scale for motor function (MDS-UPDRS III), Hoehn and Yahr (H&Y) stage, levodopa equivalent daily dose (LEDD), Beck Depression Inventory II (BDI-II) score, Montreal Cognitive Assessment (MoCA) score, nonmotor symptoms questionnaire (NMSQ), and Stendal Adherence to Medication Score (SAMS) were collected in 125 people with PD. A semistructured interview was conducted 1 month after discharge to determine the extent and reasons for medication changes. Results. Thirty-eight patients (30.4%) changed their PD medication after discharge. Most changes (20.8%) were performed by physicians while 9.6% of patients changed their medication by themselves due to side effects, missing effect of the medication, missing knowledge about the indication, running out of medication, or nonspecific reason. This led to decreased doses while changes by physicians resulted in both increase and decrease of doses as well as new drug prescription. Patients without changes, patients with changes performed by them, and patients with changes performed by physicians did not differ in age, disease duration, MDS-UPDRS III, LEDD, NMSQ, MoCA, BDI-II, gender, marital status, or education. However, patients who themselves made the changes were more likely to be nonadherent according to baseline SAMS. Patients who made changes after discharge had higher SAMS modification and forgetting subscores than patients without changes or with changes made by physicians. Conclusion. Both intended and unintended nonadherence occur in patients who change medication after discharge. The use of an adherence questionnaire during inpatient treatment may help detect patients with higher risk of changing medication after discharge.

中文翻译：

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自我报告的不依从性可预测帕金森病患者出院后药物的变化。

背景。帕金森病 (PD) 患者出院后经常更换药物。客观。这项观察性研究旨在描述出院后 PD 药物的变化，并探讨其与自我报告的依从性和临床参数的关系。方法. 在住院期间的社会人口学特征，运动障碍协会赞助的运动功能统一 PD 评定量表修订版 (MDS-UPDRS III)、Hoehn 和 Yahr (H&Y) 阶段、左旋多巴当量日剂量 (LEDD)、贝克抑郁量表 II (BDI) -II) 评分、蒙特利尔认知评估 (MoCA) 评分、非运动症状问卷 (NMSQ) 和 Stendal 药物依从性评分 (SAMS) 在 125 名 PD 患者中收集。出院后 1 个月进行半结构化访谈，以确定药物变化的程度和原因。结果. 38 名患者 (30.4%) 出院后更换了 PD 药物。大多数改变（20.8%）是由医生进行的，而 9.6% 的患者由于副作用、药物效果缺失、缺乏适应症知识、药物用完或非特定原因自行更换药物。这导致剂量减少，而医生的变化导致剂量的增加和减少以及新的药物处方。没有改变的患者、由他们进行改变的患者以及由医生进行改变的患者在年龄、疾病持续时间、MDS-UPDRS III、LEDD、NMSQ、MoCA、BDI-II、性别、婚姻状况或教育方面没有差异。然而，根据基线 SAMS，自己做出改变的患者更有可能不依从。结论。出院后更换药物的患者会出现有意和无意的不依从性。在住院治疗期间使用依从性问卷可能有助于发现出院后更换药物风险较高的患者。