{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:28:29Z","timestamp":1792189709569,"version":"4.4.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T00:00:00Z","timestamp":1606953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rotigotine patch, a trans-dermal dopamine agonist, is used acutely to replace oral dopaminergic medications for inpatients with Parkinson\u2019s disease where enteral routes are no longer available, and is also an option in end-of-life care where patients can no longer swallow. Concerns regarding acute use of Rotigotine include difficulty achieving dopaminergic equivalence, promotion of delirium\/hallucinations and promotion of terminal agitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>our objectives were to establish: (i) accuracy of Rotigotine prescribing, (ii) rates of delirium\/hallucinations and (iii) rates of terminal agitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>we retrospectively evaluated the use of Rotigotine in an inpatient population at a UK teaching hospital. Prescriptions between January 2018 and July 2019 were identified and inpatient records were analysed. OPTIMAL Calculator 2 was used as a gold standard for assessing conversion of oral dopaminergic medication to Rotigotine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>a total of 84 inpatients were included. 25 (30%) patients were prescribed the recommended dose of Rotigotine; 31 (37%) higher and 28 (33%) lower than recommended. A total of 15 of 41 (37%) patients with dementia and 22 of 49 (45%) patients with delirium before initiation of Rotigotine inappropriately received the higher dose; 20 (24%) patients developed new\/worsening delirium and 8 (10%) patients developed new\/worsening hallucinations; and 59 (70%) patients were dead at time of evaluation, of these 40 (68%) died in hospital, 10 (25%) of whom experienced terminal agitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>acute conversion of oral dopaminergic medication to trans-dermal Rotigotine patch remains problematic despite the availability of validated tools. Inappropriate dosing may precipitate or worsen delirium\/hallucinations. Use at end-of-life requires further evaluation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaa256","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T12:09:39Z","timestamp":1604664579000},"page":"1397-1401","source":"Crossref","is-referenced-by-count":22,"title":["Rotigotine patch prescription in inpatients with Parkinson\u2019s disease: evaluating prescription accuracy, delirium and end-of-life use"],"prefix":"10.1093","volume":"50","author":[{"given":"Hussein","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Medicine for Older People, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Woodward","sequence":"additional","affiliation":[{"name":"Medicine for Older People, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Pooley","sequence":"additional","affiliation":[{"name":"Medicine for Older People, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward William","family":"Richfield","sequence":"additional","affiliation":[{"name":"Medicine for Older People, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,3]]},"reference":[{"key":"2021063014063157000_ref1","article-title":"The Incidence and Prevalence of Parkinson\u2019s in the UK","author":"Parkinson\u2019s UK","year":"2018"},{"key":"2021063014063157000_ref2","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.parkreldis.2010.04.010","article-title":"The cause of death in idiopathic Parkinson's disease","volume":"16","author":"Pennington","year":"2010","journal-title":"Parkinsonism Relat 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