By Stephanie Bancroft BSc MRPharmS, PDSPN Chair
Parkinson's Disease (PD) in the UK and the role of pharmacists in supporting patients
In the UK approximately 1 in 37 people are diagnosed with Parkinson’s Disease (PD), which is caused by the loss of dopamine-containing cells in the substantia nigra (the part of your brain that helps control your movements). There is currently no cure for PD, so medication is an important part of a wider treatment plan.
Motor symptoms and treatment for PD
The three main motor symptoms (related to movement) of PD are stiffness, slowness of movement and tremor, although the condition is also associated with several significant non-motor symptoms, such as fatigue, constipation, and low blood pressure.
Levodopa remains the gold standard treatment for people experiencing motor symptoms but ensuring that medication is taken on time, every time, allows patients to control their symptoms and avoid 'off times'. ‘Off times’ occur when medication is no longer effective and can cause the patient’s symptoms to return which could include ‘freezing’. For this reason, PD medication is termed ‘Time Critical’
How the New Medicines Service (NMS) in community pharmacy can support patients with PD to manage their medication
Through the NMS, community pharmacists provide support to patients and carers, helping them manage newly prescribed medicines for a long-term condition, and supporting patients to make shared decisions about their care.
PD is now included in the NMS which is available (although not mandatory) to all patients prescribed PD medication for the first time who give consent.
The NMS is a 3-stage consultation each of which can be conducted face-to-face or on the phone.
Stage 1: Engagement, when the patient will be given initial advice about the medicine and how to use it. This can include timing (especially important for PD medication), whether to take the medicine before or after food, and likely side effects. The pharmacist can also provide additional lifestyle advice and signpost the patient to the Parkinson’s UK website for information or other resources.
Stage 2: Intervention takes place 7-14 days later at a convenient time for the patient and pharmacist ie. booked appointment/phone call.
The pharmacist will check that the patient has started to take the medication, if they think it is working, and how they are feeling.
There could be side effects which can be easily resolved, or the patient might need a referral to the prescriber for changes to be made. For PD this will be one the Specialist Parkinson’s Team (Consultant, Pharmacist, or Nurse) not the GP.
If no referral is required, a follow-up appointment is scheduled for 14 days later.
Stage 3: Follow-up
The pharmacist will check that the patient is still taking the medication, whether they have had new problems, provide additional advice and support or refer to the prescriber, if necessary
The patient will be reminded to reorder their medication so that there is no break in treatment.
Professional development opportunities for Pharmacists in PD
Any pharmacists reading this who would like to improve their knowledge of PD can join the award-winning Parkinson's Disease Specialist Pharmacy Network (PDSPN) where they will have access to a network of over 350 colleagues with an interest in Parkinson's (specialist experience not required), links to free educational support, and news of conferences and events.
For more information contact Stephanie at: pdpharmacynetwork@gmail.com
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