Supporting Medication Adherence in Parkinson's Through Education: A Scoping Review of Interventions

Medication adherence in Parkinson's is complex, time-sensitive, and influenced by clinical, behavioural, and contextual factors. Educational interventions have attempted to support medication adherence; however, the scope, focus, and effectiveness of such interventions remain unclear.

This scoping review aimed to identify and map educational interventions for people with Parkinson's that included medication-related education. Seven databases were searched with no date restrictions. Quantitative, qualitative, and mixed-methods studies were eligible. Data were charted and synthesised using descriptive mapping and reflexive thematic analysis to explore intervention characteristics, reported evidence relating to medication adherence, intervention outcomes, and reported barriers and facilitators.

Eight papers reporting seven educational interventions were included. Interventions varied widely in content, delivery mode, and intensity, with medication education often embedded within broader programmes rather than delivered as a standalone intervention. Evidence regarding the potential of educational interventions to support medication adherence was reported, although this was based on a limited number of studies using direct adherence measures and more commonly on proxy indicators such as changes in knowledge, beliefs, and self-management behaviours. Outcome measures were heterogeneous, limiting comparability. Improvements were more commonly observed in understanding, confidence, and communication than in sustained symptom outcomes. No study reported explicit use of behaviour change theory or co-design approaches involving people with Parkinson's or their informal carers.

Educational interventions show potential to support Parkinson's medication adherence, particularly through mechanisms conceptually aligned with self-efficacy. Future interventions may be strengthened by explicit use of behaviour change theory and/or meaningful co-design with people with lived experience.

A Research Involvement Manager from Parkinson's UK is a co-author and contributed to the design, conduct, and interpretation of this review, representing the perspectives of people living with Parkinson's. An advisory group comprising people with Parkinson's, carers, and healthcare professionals informed the wider research programme and reviewed the findings of this study. While no substantive changes were requested, this process supported interpretation and relevance to lived experience. Consistent with these perspectives, the review highlights a lack of co-design in existing interventions and advocates for greater involvement of people with Parkinson's in future intervention development.