Adherence to Antipsychotic Medication and Relapse Rates in Patients with Schizophrenia after Referred to Primary Care Units

Abstract

Adherence to medication and follow-up in the hospital as an out-patient visit are the main problems in patients with schizophrenia. These problems increase severe relapse rates and hospitalization. Refer patients to primary care unit (PCU) with pharmaceutical care might solve the problems. The objectives of this study were to determine (1) drug related problems (DRPs), (2) adherence to antipsychotic medication, and (3) relapse rates before and after referred patients to PCU with pharmaceutical care and psychiatric medication box. Data were retrospectively collected from electronic medical record from October 2012 to September 2018. The samples were patients with schizophrenia who visited the psychiatry clinic, Warinchamrab hospital and referred to PCU during the study period. McNemar’s test was used to compare DPRs and relapse rates. There were 152 patients in the study. it was found that after referred to PCU with pharmaceutical care and psychiatric medication box, the number of patients with non-adherence, medication safety follow-up, and adverse drug reaction were significantly decreased (p<0.05). Interaction of pharmacist with physician/nurse to avoid drug interaction, to add the medication of choice for treatment, to adjust too low dosage of treatment, and to select the most appropriate medication for treatment was significantly increased (p<0.05). The incidence of emergency visits and admissions were significantly decreased from 22 to 1 event and 11 to 4 events, respectively (p<0.05). Thus, pharmaceutical care with psychiatric medication box to PCU for patients with schizophrenia increased medication adherence and decrease hospitalization due to relapse rates. This service should be continued and be improved by developing online data to link between PCU and the hospital for the better service in the future.