4CPS-239 Pharmacy-led medication reconciliation to optimise levodopa management and minimise contraindicated drug use in hospitalised Parkinson’s disease patients: a quasi-experimental study

<h3>Background and Importance</h3> Patients with Parkinson’s disease (PD) admitted to the hospital require their usual medication routine instead of standard hospital rounds. Avoiding contraindicated drugs and ensuring proper medication timing are crucial to prevent complications. Targeted pharmaceutical care mitigates these risks and improves patient outcomes. <h3>Aim and Objectives</h3> This study evaluates the impact of pharmacy-led medication reconciliation on levodopa timing and the prescription and administration of contraindicated drugs for PD patients. <h3>Material and Methods</h3> A quasi-experimental pre-post study was conducted over 3 months (June to August 2024) for newly admitted PD patients. The intervention involved pharmacy-led medication reconciliation within 48 hours of admission, focusing on adjusting levodopa timing and preventing contraindicated drug use. PD patient admissions from 2023 were used as a comparison group. Our hospital has an alert system to flag contraindicated drugs for PD patients, which must be manually added during reconciliation. We aimed to implement the alert as early as possible. The adequacy of levodopa prescription timing and the prescription and administration of contraindicated drugs were evaluated for patients post-intervention and compared to the 2023 group. A pre-post statistical analysis was conducted using Pearson’s Chi-squared test. <h3>Results</h3> A total of 34 patients underwent medication reconciliation, with an average time of 15 hours post-admission. Among reconciled patients, 59% had levodopa timing adapted to their usual routine, and 15% had contraindicated drugs prescribed, which were subsequently suspended. Additionally, 71% of patients had alerts for contraindicated drugs added during reconciliation. A total of 34 PD episodes from 2023 were analysed as a comparison. After the intervention, the percentage of patients receiving a personalised levodopa timing plan within 48 hours increased from 51% in the 2023 group to 76% (<i>p</i> = 0.014). The prescription of contraindicated drugs decreased slightly from 22% to 18% (<i>p</i> = 0.588). However, the administration of contraindicated drugs dropped significantly from 14% to 3% (<i>p</i> = 0.035). <h3>Conclusion and Relevance</h3> Early pharmaceutical reconciliation in PD patients optimises medication management and reduces medication errors. This intervention is particularly relevant for improving patient safety and reducing complications in this high-risk population. Future research should focus on assessing the impact of these interventions on clinical outcomes, including hospital length of stay and overall patient safety. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest