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Volume 19 - Issue 2, March-April 2017
SHORT REPORTS
DRUG INTERACTION REVIEW IN A PSYCHIATRIC POPULATION
SKELLY MEGAN K, MULCAHY KIMBERLY B, TRIGOBOFF EILEEN, OPLER LEWIS, DEMLER TAMMIE LEE


Objective: The objective of this study was to examine the incidence of moderatelevel drug interactions, to categorize the most frequent drug interactions and corresponding medication combinations, and to educate healthcare providers on the importance of drug interactions involved in polypharmacy and the subsequent impact on patients’ health and safety.

Design: This is a retrospective analysis of inpatients’ medication profiles.
Setting: The study took place in a state psychiatric facility.
Participants: There were 228 patients in November 2009, 226 patients in November 2010, and 184 patients in November 2011.
Measurements: We reported the incidence of the most common moderatelevel drug interactions from both psychiatric and non-psychiatric medications. With these results, we analyzed trends for therapeutic interventions to optimize patient safety and patient outcomes for this vulnerable psychiatric population.

Results: For the same month in each successive year, the total number of moderate-level drug interactions was 1,178 in 2009, 1,276 in 2010, and 1,461 in 2011. A t-test was used to analyze whether there was a difference, and whether that difference would be statistically significant, from year to year for moderate-
level drug interactions with the drug combinations used for this sample. Amongst the three years examined, the sample of patients’ drug combinations and the number of moderate-level drug interactions were statistically significantly different (t = 17.246, p <0.003) from the first year through the third year of data. The most frequent medications involved in these drug interactions were medications with vast anticholinergic burden, first and second-generation antipsychotics, mood stabilizers, antihyperglycemics, and antihypertensives. The
top five categories for potential adverse drug reactions (ADR) from the moderate- level drug interactions in this study were central nervous system (CNS), basic metabolic, cardiac, pharmacokinetic, and pharmacodynamic.

Conclusion: This study demonstrates that psychiatric inpatients’ drug combinations have statistically significantly higher rates of moderate-level drug interactions over a three-year period. With these data, there is an opportunity to provide education to prescribers on therapeutic drug monitoring and adverse drug reactions
to minimize or prevent polypharmacy and to advance patient safety and outcomes.

DRUG INTERACTIONS – DRUG SAFETY – POLYPHARMACY – PSYCHIATRY – PSYCHOTROPIC DRUGS – STATE FACILITY



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