Effects of an Inpatient Program on Medication Errors in Hospitalized People with Parkinson's Disease.

Abstract

Hospitalized people with Parkinson's disease (PwP) face increased risks of medication errors and discharge to non-home settings, both of which are associated with adverse outcomes. This study assessed differences in medication error rates and discharge outcomes before and after implementation of a dedicated inpatient program for hospitalized PwP. During 2023, a Parkinson's disease (PD) inpatient program was implemented and refined combining: (1) an electronic health record (EHR) census for identification of hospitalized PwP; (2) inpatient monitoring and alignment of inpatient and outpatient regimens by movement-disorders-trained advanced practitioners; (3) customized EHR alerts and levodopa orders; (4) pharmacist support, and (5) staff education. Medication error rates and clinical outcomes were compared between January and June 2024 (post-implementation phase) and a pre-implementation retrospective cohort from 2018. From January to June 2024, 366 post-implementation admissions were monitored. Among those receiving contraindicated medications, the median number of doses decreased from 2 (interquartile range [IQR] = 1-6) during pre-implementation to 1 (IQR: 1-2) post-implementation (p = 0.015). Days with a levodopa dose deviation decreased from 43.1% to 38.3%, p < 0.0001, improper levodopa formulation substitutions from 18.6% to 5%, p < 0.0001, timing deviations from 72.2% to 51.8%, p < 0.00001, missed doses from 21.5% to 16.8%, p = 0.013, and discharged to non-home settings from 44.8% to 38.3%, p = 0.038. Following implementation of a multidisciplinary and proactive inpatient program, reductions in medication errors and improved discharge outcomes were observed among PwP. ANN NEUROL 2026.