Identification of the Medicine-Related Priorities for People With Parkinson's During Hospitalisation: A Systematic Review Using Meta-Ethnography.

Abstract

Background: People with Parkinson's (PwP) experience disproportionately higher rates of hospitalisation, where they encounter many medication-related challenges. Although interventions have been developed to address these issues, medication-related problems persist, and the patient's voice is largely absent from their design.

Objectives: To explore medication-related priorities during hospitalisation from the perspective of PwP to inform the development of future patient-led interventions.

Methods: A systematic review using meta-ethnography was conducted and registered with PROSPERO. A SPICE-informed search (Setting, Perspective, Intervention, Comparison, Evaluation) was undertaken across MEDLINE, PsycINFO, CINAHL, Embase and Google Scholar in June 2025. Eligible qualitative and mixed-method studies explored the perspectives of PwP regarding inpatient medication-related care. Two reviewers independently screened studies using Covidence. First- and second-order constructs were synthesised into third-order constructs representing medication-related priorities. Reporting followed Enhancing Meta-Ethnography Reporting Guidance (eMERGe), and methodological quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist.

Results: Four studies met the inclusion criteria. Four overarching themes reflected the core medication-related priorities of PwP during hospitalisation: timely and accurate medication administration, autonomy, access to skilled and knowledgeable staff, and advocacy to support patient needs. These priorities informed the development of an interpretive conceptual framework illustrating the interaction between PwP medication-related priorities and hospital systems.

Conclusions: Findings suggest the need to strengthen systems supporting timely medication administration, enable self-administration where appropriate, promote flexibility and person-centred care, and implement Parkinson's clinical champions to advocate for and support PwP throughout hospitalisation.