OBJECTIVES : To assess the impact of telephonic services on medication management of ambulatory psychiatry patients

METHODS : A prospective interventional study was conducted in psychiatry outpatient department of JSS hospital, Mysuru over a period of eleven months. All the enrolled patients were followed on their scheduled visits of ambulatory psychiatric patients. Customized patient medication counseling was provided to both patient and caretaker. Patient were followed and follow up will be reminded through telephonic contact. Hepler and Strands classification was adopted to identify drug related problems. Drug interactions were checked using Micromedex ® and Statistical analysis was carried categorically.

RESULTS : The study included 1074 patients (mean age = 36.6, 44% women)and 793 patients were under the age group of 20-40 years. A total of 1160 clinical pharmacy services were provided to639 patients that includes patient counseling (n= 639, 55.1%), pharmacist interventions (n= 367,31.6%) and drug information (n= 154, 13.2%).Amongst the pharmacists interventions, majority were related to dose correction (n=128, 35%), drug-drug interactions (n=114,31%) and rest were adverse drug reactions(ADRs) (n=67, 18%), and remaining were drug interactions. Musculoskeletal system (n= 21, 31%) and neurological class (n= 13, 19%) were affected due to ADRs. Majority of the ADRshad possible causality association (n= 48, 72%), moderately sever (Level 4a & 4b: 51% & 20%), predictable (n = 37%, 55%) but not preventable (n=41, 61%). While majority of the DDIs were moderate (n=79, 69%) in nature.Most of the interventions (n= 319, 89%) were accepted by the psychiatrists and implemented. Further, 36% of bipolar disorder, 21 % of schizophrenia, 23% of depression and 21% of other disorders were found to be poorly adherent to medications and their care givers were trained for the same

CONCLUSIONS : Clinical pharmacists' coordinated and telephonic follow-up services can help improve medication adherence in patients with psychiatry disorders.