Assistant Professor JSS College of Pharmacy Mysuru, India
Background: Treatment of psychiatric patients is complex in nature because of existing co-morbid condition, drug interaction and multiple medicine. Clinical pharmacist role in psychiatry is mainly focused in patient education, medication adherence, helping to ensure the safe use of medication; providing comprehensive drug information to patients; and supporting primary prevention.
Objectives: The study aimed to assess the outcome of clinical pharmacist-initiated medication information service in psychiatric patients.
Methods: A prospective interventional study was conducted in psychiatry outpatient department of a tertiary care hospital in Mysuru over a period of eight months. All patients who visited psychiatry outpatient department were reviewed by the clinical pharmacist. Patients who met the study criteria were enrolled and followed up for 4 months. Medication information services were provided to the enrolled patients. Assessment of clinical outcomes were performed using Clinical Global Impression and Medication Adherence Ratting Scale. Humanistic outcomes were assessed using WHO-QOL BREF questionnaire. The data of clinical condition, medication adherence, and quality of life were analyzed by paired t-test.
Results: Of the 214 enrolled patients, majority [n=123, (56%)] were male, and 178 (83%) patients were adults. Mood (affective) disorder (F30-39) was the most [n=110, 51.40%)] common diagnosis. Significant improvement observed in clinical outcome in terms of severity, gradual decrease in severity of the illness was observed from baseline [n=179, 83%] to follow up I [n=142, 75%], follow up II [n=13, 10%] and follow up III [n=2, 1%]. An increased global improvement in patients received medication information services was observed from baseline [n=1, 0.4%] to follow up I [n=6, 3%], follow up II [n=25, 19%], and follow up III [n=80, 72%]. Marked increase in efficacy index was seen from baseline [n= 2, 0.9%], follow up I [n=3, 2%], follow up II [n=83, 64%] and follow up III [n=93, 84%]. A statistically significant improvement in quality of life and medication adherence was observed from the baseline to I, II, and III follow ups
Conclusions: The study findings indicate that medication information services provided by the clinical pharmacist result in a significant improvement in clinical and humanistic outcomes among the psychiatric patients.
