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

7 Responses to “Medication timing critical in Parkinson’s disease”

  1. 1 Anonymous September 22, 2011 at 1:10 am

    My Mother had just refilled her Parkinson’s prescription and was subsequently moved to a care facility, but was unable to take those pills along with her or use up that prescription as they would not allow any medications to be used previously filled even though there was no change in the medication or dosage. They felt it was a security issue.
    The care facility is in BC.

  2. 2 Heather Gunderson September 24, 2011 at 6:51 am

    Do you have any Stats on Knee Replacement Surgery for people with Parkinsson;s? Apart from the Medication issue,I am concerned about further complications as there are already moboloty concerns.

  3. 3 Parkinson Society Canada September 28, 2011 at 10:58 am

    Moving to a care facility can be a challenge for individuals and families, as they must adapt to policies and guidance of that facility where you are typically accustomed to managing the condition independently. With that said, we do encourage people to act as their own strong advocates. The hope is that you should never have to surrender your medications without an individualized care plan to ensure that you are going to get them back on time, without missing any doses. Specific to British Columbia, we recommend that you contact your local organization at with any questions about policy and/or education available for staff. Perhaps you should also share this letter, developed by our Central & Northern Ontario Region with staff at the facility. Written from the perspective of a person with Parkinson’s it outlines why individual medication timing is so vital, and why medications should not be taken from a person living with Parkinson’s:

  4. 4 Parkinson Society Canada September 29, 2011 at 2:50 pm

    Thank you for your comment. We do not provide medical advice. Mobility concerns should be discussed with the person’s health care professional. We have a section on our website for Parkinson’s related news, that area provides up to date information in the media.

  5. 5 Harry wyma October 14, 2011 at 9:16 am

    For the “critical” timing, what I did some time ago is: I made a detailed list (spreadsheet) of all the medication my wife receives. This includes the medication name, active ingredients, and dosage, and time(s) to be taken daily. We both carry this list in our wallets as well as she in her medication bag. This we present to her specialist as well as at the hospital desk (where it is greatly appreciated). At the hospital they can either keep the list or make a copy thereof. This greatly reduces the chance of any potential mix-up or confusion. She also keeps her bag of medication with her by her bedside should ever an emergency of any kind arise.

  6. 6 Parkinson Society Canada October 17, 2011 at 11:03 am

    Harry, you’ve done something very wise here. Something, really, that everyone should consider. Step 1: Carrying a listing of your medications, dosages, timings, etc. at all times is very wise, as this can be shared with anyone who may need to see it. It is, as you say, particularly valuable when looking at medication schedules with doctors, specialists, or, when entering the hospital. Such a listing is something that we encourage through the use of our Parkinson Society Canada ‘Get it on time’ medication card. Further, your plan of having a selection of her medications at the ready, should an immediate situation arise is very wise. It means that the facility you visit will have an immediate reference, and, should also help avoid any issues with missing doses upon admittance while waiting for a new prescription to be filled etc. Again, these are both things that we strongly recommend to all people living with Parkinson’s – good for you being proactive, and, thanks for sharing!

  7. 7 Bill Ray December 3, 2011 at 12:53 am

    As a nurse I could not agree more with you, hospitals are no place for sick people. My medications are just dumped on me at their idea of a correct time, instead of reading the instructions and asking the patient what time did your doctor tell you to take them.

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All material related to Parkinson's disease contained in Parkinson Post is solely for the information of the reader. It should not be used for treatment purposes. Specific articles reflect the opinion of the writer and are not necessarily the opinion of PSC.

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