Suggested talking points
The consultation
NICE guidance for PD recommends that each PD patient is managed by a specialist multidisciplinary team, including a consultant neurologist and specialist nurse. It is rare for hospitals to have their own dedicated pharmacist so the role the community pharmacy can play with regards to their medicines is extremely beneficial.
Suggested talking points
Ensure the patient is aware that the PD medication is to control symptoms rather than cure disease and that they will need to be on treatment indefinitely. Specific PD medications will target motor symptoms or dyskinesia.
Many medical professionals refer to PD medications by their branded names. Many internet forums allude to there being a difference in efficacy between branded and generic versions and this can be a cause for concern to a patient. There is no stipulation that requires PD medications to be prescribed by brand.
The medication regimen is tailored to each individual person because PD affects people differently. Symptoms can vary hour by hour and minute to minute so it is important that each patient takes their medications at the time that is right for them as this is likely to be when the last dose is starting to wear off. This is a key point to reinforce.
For many reasons, some patients do not start medicines immediately. There could be fear concerning side-effects, and/or poor understanding of what the medicine is being used for. It is important to provide assurance regarding any inhibitions to taking the medicine.
We know that people with PD sometimes miss some doses of their medicines. Some people may forget due to a variety of reasons. Sometimes there is cognitive decline and/or some early memory loss. Advise them to set timers or use compliance aids to help with timely medication administration. There may be a package of care set up with carers who also help with medicines administration. Family members can also help to prompt with timely administration of medicines.
Swallowing difficulties can be an issue which can occur at any stage. Different formulations (e.g. dispersible forms or patches) can help. Excess saliva or drooling may be apparent during a consultation, which can be a sign of swallowing difficulties.
Tremor, shaking and rigidity are all common symptoms of PD which can make it difficult to get medicines out of the pack/bottle. Work out ways with the person to make it easier (e.g. compliance aid).
The PD society runs local community groups, which join PD patients together, and also offers a lot of support resources.
Additional information:
