{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:22:53Z","timestamp":1787311373913,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with Parkinson's disease (PD) frequently present to the Emergency Department (ED). Whether for PD\u2010related complications or unrelated concerns, maintaining their antiparkinsonian medication regimen without interruption is crucial. Delays or omissions can lead to significant morbidity and mortality. Despite this, the importance of timely ordering and administration of antiparkinsonian medications is often underrecognized in the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective chart review across a single health system comprising one academic and five community EDs, three of which are critical access hospitals. Adults aged \u2265\u200965\u2009years with an active outpatient carbidopa\u2010levodopa (C\u2010L) prescription presenting between September 1, 2024, and August 31, 2025, were included. The primary outcome was the proportion of patients who received their prescribed C\u2010L during the ED encounter. Timeliness was assessed using two definitions: a primary, idealized standard of administration within 30\u2009min of the scheduled dose, and a secondary, system\u2010based standard of administration within a two\u2010hour window.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 282 patient encounters involving 87 unique patients were included (mean age 80.1\u2009years; 61.7% male; 99.3% White). Mean ED length of stay (LOS) was 8\u2009h and 53\u2009min. C\u2010L was administered in only 91 encounters (32.3%). Among the 282 ED encounters, 12 (4.3%) met the idealized timeliness definition for C\u2010L administration, and 18 (6.4%) met the system\u2010defined standard. Among the 91 encounters with a C\u2010L order, 13.2% met the ideal definition and 19.8% met the system standard. Mean time from ED arrival to medication administration was 6\u2009h 11\u2009min. Most administrations occurred 1\u20134\u2009h (39.6%) or 4\u20138\u2009h (26.4%) after the scheduled dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Less than one\u2010third of older adults with PD received their home antiparkinsonian medication in the ED, and fewer than 10% received it on time. Targeted interventions to ensure timely medication administration are needed to prevent iatrogenic harm in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70269","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:42:01Z","timestamp":1774881721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An Underrecognized Problem: Missed and Delayed Carbidopa\u2010Levodopa Administration in Emergency Department Patients With Parkinson's Disease"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-6368","authenticated-orcid":false,"given":"Natalie M.","family":"Elder","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine The Robert Larner College of Medicine at the University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica M.","family":"Lash","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine The Robert Larner College of Medicine at the University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Tomkins\u2010Tinch","sequence":"additional","affiliation":[{"name":"Independent Researcher"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-181474"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10333"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2013.06.006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20485"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2401857"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2009.080432"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2006.11.006"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2018.09.016"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30295-3"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.22360"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0000000000001362"},{"key":"e_1_2_10_13_1","first-page":"1465","article-title":"Impact of Medication Reconciliation for Improving Transitions of Care","volume":"8","author":"Redmond P.","year":"2018","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.02.008"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2022.05.012"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.70269","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:03:19Z","timestamp":1777438999000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.70269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/acem.70269"],"URL":"https:\/\/doi.org\/10.1111\/acem.70269","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"assertion":[{"value":"2025-11-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70269"}}