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FACTORS THAT MODULATE COMPLIANCE TO REHABILITATION PROGRAMS IN PATIENTS WITH PARKINSON'S DISEASE
Prada G, Fita I, Tutu-Pata V, Prada S
Dysfunction and loss of independence are associated with depression in patients with Parkinson's disease. In addition, medical rehabilitation of these patients can be affected by anti-parkinsonian medication, but also by concurrent drugs administered for concomitant diseases. The present study aimed at demonstrating the influence of various medicines on adherence of patients with Parkinson's disease to functional rehabilitation programs. A total number of 187 patients have been included, 52% men and 48% women, age range 45 and 80 years. Effects of anti-parkinsonian and psychotropic medication upon motor, vegetative and psychic disorders characteristic to Parkinson's disease have been evaluated, as well as their influence upon patient's compliance. All classes of anti-parkinsonian drugs had negative effects, especially orthostatic hypotension produced mainly by dopaminergic agonists and digestive complaints (nausea, pain, constipation) have been generate by all medicines. Psychotropic medication can increase both motor dysfunctions specific to Parkinson's disease and pre-existent depression and anxiety. These factors are frequently ignored especially if the clinical pictures is dominated by motor complaints and the side effects are moderate, but importantly enough to interfere with patient's adherence to rehabilitation program. A constant evaluation of the degree medication can influence the specific symptoms of Parkinson's disease is necessary. The authors suggest some original algorithms to be used for this assessment.
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