An Ambulatory Care Pharmacist’s Perspective on Individualizing Parkinson Disease Management

In this interview, Eduardo Martinez Sanchez, PharmD, CPh, BCPS, BCACP, ambulatory care pharmacist at Baptist Health South Florida shares his insights into the early presentation and progression of Parkinson disease. He explains that early symptoms are often subtle and may include resting tremor, bradykinesia, muscle stiffness, and balance changes, along with nonmotor symptoms (eg, loss of smell, sleep disturbances, constipation, and depression). As disease progresses, symptoms worsen and affect both sides of the body, requiring treatment plans to evolve. Therapy is highly individualized, with early management focused on mild symptom control and later stages requiring more complex medication regimens, dose adjustments, and management of fluctuations.

Martinez Sanchez emphasizes the critical role ambulatory care pharmacists play in Parkinson disease management. Pharmacists collaborate closely with patients and health care teams to ensure medications are used safely and effectively, particularly given the importance of precise timing and dosing. They provide patient and caregiver education, support adherence, and help manage both motor and nonmotor symptoms. Additionally, pharmacists contribute to optimizing complex treatment regimens through comprehensive medication reconciliation, aligning dosing with daily routines and meals, and addressing polypharmacy and transitions of care to improve overall outcomes.

Additionally, the discussion also addresses key counseling points for newly diagnosed patients, including strict adherence to medication timing, understanding treatment expectations and adverse effects, tracking symptoms, maintaining healthy routines, and involving caregivers. Martinez Sanchez shares Baptist Health South Florida’s leadership in Parkinson care, citing its team of movement disorder specialists, advanced diagnostic tools, and access to cutting-edge therapies such as deep brain stimulation and focused ultrasound. He also points to promising developments in the treatment pipeline, including investigational therapies like prasinezumab, gene and cell-based approaches, and emerging data on GLP-1 agents and novel dopamine agonists. He encourages patients to remain hopeful, stay engaged with their care teams, and recognize that treatment must be individualized throughout their journey managing Parkinson.