A novel study on clinical pharmacist and psychiatrist collaborative pharmacotherapy management services among elderly population with psychiatric illness

BACKGROUND: Geriatric psychiatry has yet to receive its due recognition in India. There is increasing evidence of a rise in morbidity, mortality, hospitalization, and loss of functional status related to common mental disorders in the elderly patients. Collaborative care approach, including a clinical pharmacist, is one of the possible approaches to cope with geriatric patients with psychiatric patients. OBJECTIVE: The study aimed to assess the impact of pharmacotherapy management of geriatric patients in collaboration with pharmacist and psychiatrist. MATERIALS AND METHODS: A prospective interventional study was conducted in the psychiatry outpatient department of a tertiary care hospital in Mysore over 6 months. Geriatric patients who were newly diagnosed with depression, bipolar affective disorder (BPAD) and alcohol dependency syndrome (ADS) were included in this study. The clinical pharmacist scrutinized the patients for their participation in the study. Included patients were followed up on monthly basis for up to 4 months. Pharmacotherapy management was provided to the enrolled patients. Interventions provided were discussed with the psychiatrist. Descriptive analysis was performed for categorical variables. RESULTS: A total of 84 geriatric patients were enrolled in the study. Majority of the enrolled patients were female (n = 46, 54.7%). Nearly half of the patients were illiterate (n = 40, 47.6%) and unemployed (n = 38, 45.2%). Among the enrolled patients, half of the study participants were diagnosed with depression (63.09%) followed by BPAD (27.38%), Schizophrenia (7.14%), and ADS (2.38%). A total of 155 medication information services were provided to 84 patients including patient counseling (n = 84, 100%), pharmacist interventions (n = 48, 30.96%) and medication information (n = 23, 14.83%). Most of the interventions were adverse drug reactions followed by drug-drug interactions, failure to receive drugs, untreated indication, subtherapeutic dose, drug use without indication, and overdose. Majority of the interventions (n = 46, 95.8%) provided were accepted by the psychiatrist. CONCLUSION: The study findings indicate that pharmacotherapy management services provided by the clinical pharmacist in collaboration with the psychiatrist benefited the geriatric psychiatric patients.