It is extremely important to remember that Parkinson’s medication should never be withdrawn abruptly or allowed to fail suddenly due to lack of absorption (e.g. in gastroenteritis or abdominal surgery) due to the risk of acute akinesia (total loss or impairment of the power of voluntary movement for the person – akin to paralysis) or neuroleptic malignant syndrome occurring.

People with PD who are hospitalised, awaiting surgical procedures or admitted to care homes should have their medication given to them at the times appropriate to them and not the local organisation (self medication should be a preferred option).

Parkinson’s UK has published guidance for community and hospital pharmacists on the most appropriate use of PD medicines. For details, see: Key information for community pharmacists booklet.

PD is a fluctuating and debilitating disease; the efficacy of pharmacological treatments fluctuates as well as the response to treatment. The person with PD needs support and understanding. Remember that trapped within an uncooperative body is a cognitively intact person.

Communicating with patients

The clinical features of PD profoundly affect the individual’s ability to communicate and can also prejudice how people communicate with them. This is because the altered body language and facial expressions of people with PD can seem threatening to others. Remember that 55 per cent of communication is via body language, 38 per cent dependent on tone and volume and only seven per cent on the words spoken. As a pharmacy professional it is important that you adapt your communication skills to help the person communicate effectively with you. Due to reduced speech volume, conversations may be better in a quiet consultation room rather than at the front counter.