Initiation of medications for Parkinson's disease: a qualitative description

Aims and objectives. To understand experiences of people with Parkinson's disease to initiate medication therapy for Parkinson's disease. Background. Nonadherence to medication regimens and reluctance to initiate medication therapy among people with Parkinson's disease has been documented in previous research. However, little is known about experiences and decisions of people with Parkinson's disease to initiate antiparkinsonian medications and their beliefs or levels of understanding of antiparkinsonian medications in the USA. Design. An exploratory, descriptive qualitative study was employed. Methods. Semi-structured interviews were conducted with 16 community-dwelling individuals with Parkinson's disease (69% male) and five family caregivers (40% male). Data analysis was performed using content analysis. Results. Two domains emerged from the data: decision-making to initiate antiparkinsonian medications as prescribed and reasons to delay initiation of levodopa to a later stage of Parkinson's disease. Conclusions. Acceptance of antiparkinsonian medications at the early stage of Parkinson's disease was influenced by the trusting relationship between participants and their health care provider. Fear of levodopa's long-term side effects led to acceptance of non-levodopa therapies first. Complementary and Alternative Medicine was used to manage Parkinson's disease symptoms among participants who delayed antiparkinsonian medication therapy. Relevance to clinical practice. Nurses may have a role to assess individuals' beliefs and concerns about antiparkinsonian medication therapy and to provide adequate information to assist with the decision about Parkinson's disease symptom management.