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Parkinson’s Reviews in Primary Care: 3 Crucial Considerations for Pharmacists

Updated: Jan 8


Male pharmacist sat at a desk talking to a patient virtually on his laptop.

Pharmacists play a pivotal role in the management of Parkinson's disease. Our expertise in medication management, patient education, and condition monitoring is essential for improving the quality of life for those affected by this condition. Inspired by our latest podcast episode, this article shares 3 key aspects that pharmacists must consider when conducting Parkinson’s reviews.

 

1. Constipation Management


Constipation is a common yet often overlooked issue in Parkinson's patients. The role of dopamine in gastrointestinal motility means that Parkinson's patients frequently experience slowed bowel movements. This can affect the efficacy of Parkinson's medications like Co-careldopa or Sinemet, as prolonged bowel retention may hinder absorption, reducing the medication's benefits. Consequently, inquiring about constipation is one of the key questions for pharmacists to prioritise in a medication review.


For constipation management, pharmacists should review the patient's current medication regimen to avoid excessive drug usage while ensuring effective treatment. This may involve dietary advice and prescribing osmotic, bulk-forming or stimulant laxatives tailored to the patient’s specific needs.


 

2. Optimising Medication Timing


The effectiveness of condition management in Parkinson's patients is significantly influenced by its timing. Pharmacists should inquire about their patients' daily routines, including their waking and bedtime schedules, as well as their regular activities.


Altering the timing of Parkinson’s medication to better coincide with the patient's routine can improve drug effectiveness and adherence. For instance, administering a dose earlier or later in the day may be more advantageous, depending on the individual's lifestyle and symptoms.


 

3. Monitoring for Impulsive Behaviour


In advanced stages of Parkinson's disease, patients may be prescribed dopamine agonists (e.g., Ropinirole) to increase dopamine levels in the brain. While effective, these medications can heighten the risk of impulsive behaviours, such as gambling or hypersexuality.


It is imperative for pharmacists to educate patients and caregivers about the potential side effects of these medications. Raising awareness about the signs and symptoms of these behaviours can enable early detection and intervention for the patient.


 

In Summary


Addressing issues such as constipation, medication timing, and impulsive behaviour during Parkinson’s reviews is essential for optimising treatment outcomes. Through this proactive engagement and patient education, pharmacists can significantly contribute to the effective management of Parkinson's disease in primary care settings.


If you’d like to learn more, please access our comprehensive Parkinson’s review training programme here.



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My husband first symptoms of Parkinson’s occurred during covid, but was diagnosed in 2021 when he was 61 years. He was on Levodopa- not crazy about it! he was also on Sifrol and rotigotine not crazy about any of it either, The Levodopa did very little to help him. The medical team did even less. His decline was rapid and devastating. He had a stooped posture, tremors, muscle stiffness and even slow movements. I was a master Gardener and love herbs! This Parkinson’s took my life from me, I was no longer able to work in my garden anymore because I was a full time caregiver for my husband. We stopped most of his Parkinson’s medications due to severe side…

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