Impact of pharmacist-physician collaboration on patient outcomes in Parkinson's disease: a randomised controlled trial in tertiary care.

Abstract

Background: Previous studies have shown that reducing drug-related problems (DRPs) may improve therapeutic outcomes in patients with Parkinson's disease (PD).

Aim: To investigate the impact of pharmacist participation in Parkinson's disease clinic on the number of DRPs, clinical outcomes, and the quality of life of PD patients.

Method: This single-blinded randomised controlled trial was conducted at the Parkinson's Disease and Movement Disorders Clinic. Patients aged ≥ 18 years, diagnosed with idiopathic PD for at least 3 years, and receiving antiparkinsonian drugs were randomly assigned (1:1) to the pharmacist-physician (PP) or usual care (UC) groups. The primary outcome was changes in the number of DRPs from baseline to 24 weeks between groups. Secondary outcomes included the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) score, eight-item version of the Parkinson's Disease Questionnaire (PDQ-8) score, and Patients' Global Impression of Change (PGIC) score at week 24.

Results: A total of 80 patients were randomised, with 40 in each group. The mean number of DRPs reduced in both groups; however, the reduction was greater in the PP group compared to the UC group (- 7.2 ± 3.6 vs. - 3.0 ± 1.8, p < 0.001), especially non-adherence issues. The MDS-UPDRS and PDQ-8 scores showed significantly greater improvement in the PP group. A higher proportion of patients in the PP group achieved improvement in PGIC scales compared to those in the UC group.

Conclusion: Our findings demonstrated that pharmacist-physician collaboration service in the PD clinic positively impacted patient outcomes.

Trial registration: ClinicalTrials.gov NCT05410210 (date 13 May 2022).