Objective:

To evaluate the accuracy and timeliness of in-hospital administration of carbidopa-levodopa in patients with Parkinson Disease.

Background:

Patients with Parkinson Disease (PD) are at considerable risk of hospitalization due to baseline disturbances in balance, gait, and swallowing dysfunction. Many PD patients have strict regimens for dopamine-replacing agents, and disruption to these schedules can lead to uncontrolled symptom management, as well as other medical and psychiatric adverse events. During hospitalization, patients may face multiple challenges in getting their carbidopa-levodopa (CL) medications on time. This project aims to evaluate how often CL was not given on schedule across our hospital system.

Design/Methods:

We reviewed 101 patients with a diagnosis of PD admitted to our hospital system between 2021 and 2025. Patients not on any form of CL were excluded from this study. Home medication lists were reviewed for each patient and compared to the inpatient Medication Administration Record (MAR), including the dosage, formulation, and scheduled frequency. Administration time of each CL dose was logged. Doses of CL not given within 15 minutes of a patient’s prescribed home schedule were considered improperly timed.

Results:

All patients reviewed had the correct dosage, formulation, and frequency of their CL ordered while hospitalized. However, adherence to home dosing schedules varied widely. A total of 947 CL doses were reviewed, with 590, or 62.3%, of doses found to be incorrectly timed.

Conclusions:

Our analysis found that the majority of CL doses were not administered to hospitalized CL patients within a timely manner. Coordinating accurate and timely CL administration for hospitalized PD patients can be understandingly difficult for providers and staff less familiar with these regimens. This project aims to provide awareness and underscore the importance of adhering to proper PD medication times. Multidisciplinary coordination among clinicians, pharmacy, and nursing staff is essential to optimize inpatient care for individuals with PD.