RT Book, Section A1 Chen, Jack J. A1 Dashtipour, Khashayar A2 DiPiro, Joseph T. A2 Talbert, Robert L. A2 Yee, Gary C. A2 Matzke, Gary R. A2 Wells, Barbara G. A2 Posey, L. Michael SR Print(0) ID 1148575161 T1 Parkinson Disease T2 Pharmacotherapy: A Pathophysiologic Approach, 10e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9781259587481 LK accesspharmacy.mhmedical.com/content.aspx?aid=1148575161 RD 2021/03/05 AB Patient Care Process for the Management of Parkinson DiseaseCollectPatient characteristics (e.g., age, race, sex, hand dominance)Patient history (past medical, family, social—dietary habits, alcohol and tobacco use)Motor and nonmotor symptoms (see Table 59-1 and 59-2)Current medications, prior medication use for Parkinson disease and response to prior medications for Parkinson disease (e.g., effectiveness, side effects), prior use of dopamine receptor blockersObjective dataheight, weightLabs (e.g., Scr, LFT)Other diagnostic tests when indicated (e.g., neuroimaging)AssessPast and current use of medications associated with drug-induced parkinsonism (e.g., antipsychotics, metoclopramide, tetrabenazine)Difficulties with performing activities of daily livingGait difficulties and fall risk Motor or nonmotor symptoms that are most troublesome for the patientAppropriateness, effectiveness, and side effects of current medications for the motor and nonmotor symptoms of Parkinson diseasePresence of motor complications (e.g., motor fluctuations, dyskinesias, freezing)Plan*Tailored lifestyle modifications (e.g., exercise)Drug therapy regimen including specific medications for Parkinson disease, dose, route, frequency, and duration; specify the continuation and discontinuation of existing therapies (see Table 59-3)Monitoring parameters including efficacy (e.g., symptom improvement, safety (medication-specific adverse effects; see Table 59-4), and timeframePatient education (e.g., purpose of treatment, lifestyle modification, drug therapy, side effects)Self-monitoring of symptoms—where and how to record resultsReferrals to other providers when appropriate (e.g., physician, physical therapy, speech therapy)Implement*Provide patient education regarding all elements of treatment plan Use motivational interviewing and coaching strategies to maximize adherenceSchedule follow-upFollow-up: Monitor and EvaluateDetermine symptom relief goal attainmentPresence of adverse effectsOccurrence of motor complications, falls, and development/progression of non-motor symptomsPatient adherence to treatment plan using multiple sources of information*Collaborate with patient, caregivers, and other health professionals