Parkinson's Disease Clinical Trial
Official title:
European Study of Therapeutic Compliance in Parkinson's Disease
In both symptomatic and asymptomatic disease, only about half of medicines are taken as prescribed1. Relatively little is known about how patients with Parkinson's disease take their medication. One of the challenges in the management of Parkinson's disease is the prevention and treatment of involuntary movements2,3 and wild fluctuations between being mobile and able to function against being slow, stiff and unable to move which recurs as a delayed (several years) effect of taking antiparkinson medication. One theory of why this occurs is that it is due to pulsatile rather than continuous delivery of medication to the brain4. If patients take their medicines erratically and irregularly, this causes more fluctuations in blood and therefore brain drug levels may prime patients for complications in the future. This project will define the extent of irregular medication taking in Parkinson's disease, examine associated clinical and demographic characteristics and examine the ease of adherence to different drug regimes. Knowledge of therapy adherence will help support patients in using their medicines to best effect. In the present document the terms compliance and adherence are used with equal meaning.
This is an observational study of how patients with Parkinson's disease take their
medication. Antiparkinson medication will be monitored using electronic pill bottles, MEMS,
Aardex®, Switzerland (which contain a microprocessor in the cap that records the time and
date of bottle openings). This gives information about the amount of prescribed medication
taken (total compliance), the percentage of days when the correct number of doses is taken
(daily compliance), and the percentage of doses taken at the correct time interval (timing
compliance).
Five countries will be involved, (UK, Germany, Italy, Spain and France). The total number of
patients recruited across Europe will be 144. The study size has been calculated based on a
single centre study in Glasgow where 2/3 of 120 patients were scheduled to undergo
electronic monitoring as part of a different study design. Accordingly data is available
which has informed the expected number of patients completing the study (around a 10% drop
out rate) and in order to test 6 key variables with potential influence on therapy
compliance and using the general statistical guide that between 10 and 20 patients should be
studied per variable to be examined, a sample size of around 120 evaluable patients has been
calculated.
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