Late Doses, Lost Function: A Hospital Audit of Parkinson’s Medication in Older Adults

Abstract Background Timely administration of Parkinson’s disease (PD) medications is essential to maintaining motor function and preventing complications, particularly in older adults. Medication delays/omissions in hospital are associated with adverse outcomes, including; increased morbidity; longer hospital stays and functional decline. This audit evaluated inpatient PD medication management in a level 4 hospital, focusing on prescribing accuracy, administration timing, and documentation practices. Methods We conducted a retrospective chart audit involving 30 inpatients with PD who were acutely admitted over a 6-month period in our centre. We reviewed missed or delayed doses, prescribing errors, and documentation of medication events. We applied the NICE guidelines on Parkinson’s disease as our standard. We recorded descriptive data and analysed for comparisons between specialties using Fisher’s exact test (p<0.05 considered significant). Results 30% (9/30) received all PD medications on time. 70% (21/30) experienced at least one missed or delayed PD dose. 12/30 (40%) had doses omitted entirely; 50% (15/30) received delayed doses (median delay: 2.3 hours (range 0.5-9). Prescribing errors occurred in 20% (6/30) of patients, including medications omitted on admission and incorrect dosing frequency. Reasons for missed/delayed doses were absent in 76% (22/30) of cases. Errors occurred across all wards and specialties, with no significant variation between medical and surgical services (p=0.64). Formal medication reconciliations were completed in only 13% (4/30) of cases. Conclusion This audit identifies systemic issues in PD medication management for hospitalised older adults in our centre. These findings support a broader need for hospital-wide governance measures to safeguard the care of older patients with Parkinson’s disease. We have liaised with staff by providing education to support understanding and compliance across our centre. The audit cycle will be repeated in 6 months time to ensure improvements to practice.