Medication Adherence in Parkinson's Disease: Longitudinal Changes and the Influence of Depressive Symptoms.

Purpose: Parkinson's disease (PD) is a progressive neurodegenerative disease. As the disease progresses, medication regimens become increasingly complex. The long-term success of PD pharmacotherapy is highly dependent on patient adherence to the prescribed medication regimen. The aim of this study is to investigate how intentional and unintentional non-adherence evolves over time and to identify PD-related factors that influence these longitudinal changes. These findings may be crucial in developing targeted interventions to improve adherence, particularly in patients who have difficulties with intentional or unintentional non-adherence.

Patients and methods: The sample consisted of 91 people with PD who were initially treated as part of the PD multimodal complex treatment at the Department of Neurology, Jena University Hospital, Germany. They were followed up three and six months after discharge. Medication adherence was assessed using the Stendal Adherence to Medication Score (SAMS) and its three subscores for forgetfulness, knowledge, and modification. Statistical analyses included Wilcoxon signed rank test, Friedman test, and generalized estimating equations to determine longitudinal changes in non-adherence and the influence of PD-related variables.

Results: Analysis of SAMS subscores showed improvement over time in modification and knowledge, whereas forgetfulness did not show significant change. Modification was significantly associated with depressive symptoms.

Conclusion: Medication adherence in PD is a dynamic process and changes over time. The findings suggest that while educational interventions are effective in improving knowledge and reducing intentional non-adherence, addressing depressive symptoms and cognitive impairment is critical to improving overall adherence. Future research should continue to explore the factors that influence adherence behaviors and develop targeted strategies to help people with PD maintain adherence throughout the course of their disease.