Initiating Apomorphine Therapy Without Antiemetic Pretreatment: Real-World Data From a Nurse-led Parkinson Disease Support Program.

No a priori statistical analyses were planned, so the associations are post hoc. Reasons for discontinuation were not captured, so 90-day continuation was used only as a surrogate for tolerability. Trimethobenzamide use was inferred from a reminder phone call indicating it was dispensed, not directly observed. The database lacked specific adverse event data, so nausea, vomiting, and other harms were not measured. Patients opted in to the nurse program, so results may not apply to patients who decline or lack access. The database lacked demographic and prescriber information, so patient selection may have changed when trimethobenzamide became unavailable. Other reasons for discontinuation, such as device use, cost, or non-gastrointestinal adverse effects, could not be excluded. Nurse education, prescriber-directed dosing, flexible titration, and calendar-year changes occurred together, so their separate contributions cannot be separated.

The data came from a manufacturer-sponsored nurse navigator program delivered through a third-party contractor. The supplied text does not include a separate conflict-of-interest declaration.

Do not read 83.2% continuation without trimethobenzamide versus 75.4% with it as evidence that skipping trimethobenzamide improves outcomes. The difference was not statistically significant, the analysis was post hoc, and all patients also received prescriber-directed dosing and nurse program support.