Lower LEDD and Polypharmacy Rates Beyond the Honeymoon Period in Patients With Parkinson's Disease Integrative Western–Korean Medicine Interventions: A CARE-Compliant Case Series

TL;DR

This study shows that combining Western and Korean medicine may reduce medication use and levodopa doses in long-term Parkinson's patients.

Contribution

The study presents a novel integrative treatment approach for PD that lowers LEDD and polypharmacy rates beyond the early disease stage.

Findings

Integrative treatment led to a mean LEDD of 321.71 mg, with only two patients exceeding 300 mg.

Polypharmacy was observed in 13.3% of patients, lower than previous reports on conventional treatments.

Case examples showed symptom improvement and reduced medication needs with acupuncture and herbal medicine.

Abstract

Parkinson's disease (PD) is the second most common neurodegenerative disorder with significant social costs, mainly owing to hospitalization, which is frequently associated with high levodopa equivalent daily dose (LEDD) and polypharmacy rather than neurological symptoms alone. Integrative treatment combining Western and Korean medicine may help control these factors and reduce the need for hospitalization. We investigated the potential impact of integrative treatment on LEDD and polypharmacy in patients with PD > 5 years postdiagnosis.

Fifteen patients with PD (KCD code G20), diagnosed > 5 years earlier, who received integrative treatment at Gwangju Korean Medicine Hospital, Wonkwang University, from April 1, 2022, to July 30, 2024, were enrolled. A retrospective chart review was conducted to collect demographic and clinical data, including LEDD, medication count, and treatment details. Summary statistics were presented as median (IQR) and mean ± SD.

In the integrative treatment cohort, the prevalence of both LEDD and polypharmacy was lower than that in studies involving conventional treatment alone. The mean LEDD was 321.71 (median, 200.0) mg, while only two patients exceeded the LEDD threshold of 300 mg, which was associated with motor complications. Polypharmacy was observed in 13.3% of patients and hyperpolypharmacy in 6.7%, representing lower proportions compared with previous reports on conventional treatments. Representative cases highlighted symptom improvement and a reduced need for medication with integrative approaches, particularly acupuncture and herbal medicine.

These findings suggest that integrative treatment may contribute to lowering LEDD and medication counts in patients with PD, which could potentially reduce hospitalization rates and the associated social costs. Further prospective studies comparing the integrative and nonintegrative treatment groups are needed to clarify these findings and evaluate the role of integrative treatment in the long-term management of PD.

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