Medication timing critical in Parkinson’s disease


(This article appears in the September 2011 edition of Hospital News)

A one-week disruption of his Parkinson’s medication schedule resulted in nearly three months of distress for Lorne Collis after he returned home from a brief hospital stay for a kidney ailment in December 2009. “My tremors were uncontrollable,” says Collis. “My restless legs syndrome was extremely uncomfortable. It took about three months of getting back on my medication routine and exercising before my body felt normal again.”

Get it on timeIt’s a common experience. People with Parkinson’s enter hospital for reasons that may or may not be related to Parkinson’s and find that the hospital’s drug rounds do not coincide with their own medication regimen. However, in Parkinson’s, a minor change in medication timing can have major negative effects on symptom management and general recovery.

The uneven release of dopamine can result in a person suddenly not being able to move, get out of bed or walk down a corridor. It can also lead to serious complications such as aspiration pneumonia and bowel obstruction.

“When Parkinson’s symptoms get out of control, it tends to exacerbate the reason why the person is in hospital.” says Barbara Snelgrove, director of education and support services for Parkinson Society Canada. “It also makes care of the person more difficult for healthcare professionals.”

To address these issues, Parkinson Society Canada is the first Parkinson’s organization in North America to introduce Get it on time, an innovative education and awareness program designed to ensure that people with Parkinson’s receive their medication on time, every time, whether they are in emergency rooms, hospital wards, or long-term care facilities.

Get it on time was developed and implemented successfully by Parkinson’s United Kingdom. Parkinson Society Canada has adapted it to the Canadian healthcare environment, with financial support from the Canadian Institutes of Health Research and the Canadian Patient Safety Institute.

Launched in January 2011, the program uses the voices of people with Parkinson’s and their care partners to target the Get it on time message to nursing staff and front line health professionals through in-service training and communication tools such as information kits, posters and Get it on time stickers to attach to patients’ charts or care plans.

The program also has a self-advocacy component, encouraging people with Parkinson’s to bring their own medication to the hospital or care facility and inform staff about their precise medication needs, using the Get it on time medication card.

“We’re approaching this on many layers,” says Debbie Davis, chief executive officer of Parkinson Society Central & Northern Ontario, one of the regions piloting the national program. “We know that it can improve quality of life for people with Parkinson’s while they are in hospital or in a care facility. We also know that the people caring for them will have an easier time if they are educated as to what Parkinson’s is and what they can do to make people’s lives better.”

To date, over 50 Get it on time presentations have been made to long-term care facilities, retirement residences and Parkinson’s support groups in Ontario. The campaign will expand to Ontario hospitals, this fall.

Get it on time is also being piloted in communities in Saskatchewan. In French, it is called Le prendre à temps. Parkinson Society Canada is seeking funding to roll out the program nationally.

Lorne Collis has already benefited from Get it on time. In hospital recently for complications relating to Crohn’s disease, he says, “Because of my knowledge of the Get it on time program, I advocated for myself. I said, ‘these are the times I take my pills – 6 a.m., noon, 5 p.m., 9 p.m.’ One nurse had a relative with Parkinson’s, so she understood. She spoke to the charge nurse. They allowed me to take my own pills at my scheduled times. When I left hospital, this time, my Parkinson’s symptoms were fine and totally under control. It made a huge difference.”

For more information about Get it on time, contact

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