The use of polypharmacy has become significantly more common over the past two decades, increasing the risk of drug-drug interactions and adverse drug reactions. Pharmacogenomic (PGx) assays have the purported benefit of being able to predict an individual's response to a specific medication based on genetic markers, which may facilitate the development of optimized medication regimens for patients prescribed polypharmacy. This 12-week pilot study examined the impact of the PGx results on the clinical management of Veterans who were prescribed psychiatric polypharmacy. Psychiatric medication providers were given access to the PGx assay results, including notification of drug-drug-gene interactions computed from an algorithm decision tool, to assist with medication management decisions. Veteran outpatients (N = 53) prescribed polypharmacy (mean = 13.15 medications) were enrolled into the study. In 92.4% of cases, providers changed medications at baseline, with 83% of providers indicating that they changed their original medication plan based on the PGx results. Clinical improvement over the 12-week treatment phase was seen in depression (F(1.63, 45) = 5.45, P = .01, η 2 = .11) and mental health quality of life (F(2.00, 45) = 4.16, P < .05, η 2 = .16). Adverse drug effects were unchanged or improved over time. Rates of polypharmacy remained unchanged. The results suggest that medication changes based on the PGx assay may be beneficial in a complex patient population prescribed polypharmacy.

Aims:The medium stay unit of the hospital of Zamudio is a psychiatric hospitalization unit where serious patients are admitted, specially those with psychotic and affective disorders. The complexity of the pathology extends the average stay of hospitalization with an average of 60 days to improve.There are 2 derivation units from which medium stay takes patients:•Short stay unit from the Hospital of Cruces;•Short stay unit from the Hospital of Zamudio.Methods:It is analyzed, retrospecitvely, the profile of patients in a medium stay unit comparing the derivation unit they come from in 2007.Results and conlusions:There are no statistically significant differences in the number of patients derived from the diverse units.The sociodemographic and administrative profile of the patients is similar in both groups: a single middle aged (between 45-50 years old) that is hospitalized knowlingly (63%). The average stay at hospital is 55 days.Attending to the clinical profile we concluded that patients derived from the Hospital of Zamudio suffer from Bipolar disorder as main diagnosis. The rest of disorders remain similar comparing both units.

Aims:A medium stay unit is a psychiatric hospitalization unit where serious patients are admitteded, basically those with psychosis and affective disorders. The complexity of the pathology extends the average stay of hospitalization with an average of 60 days to improve.The general profile of patients in a medium stay unit is characterized by:•Psychotic and affective disorders that need longer hospitalization.•Disorders that are resistant to treatment and need specific strategies.•Patients that give up the treatment.•Patients that require sessions of electoconvulsive therapy.Methods:It is analyzed, retrospectively, all admission to a medium stay unit in 2007 and described the clinical and sociodemographical features of each patient entering the unit.Results:209 people enter the unit in 2007, most of them single and in average they are 47 years old. The relation between men and women is similar.The 65% of the patients agree about being hospitalized with an average stay in hospital of 54 days.Schizophrenia is the most frequent diagnosis, followed by Major Depression.The 56% of the patients are referred to an outpatients' department.Conclusions:What we observed in our study fits in with the general profile of patients that entered a medium stay unit.

Aims:Comorbidity between drug misuse and mental disorders affects negatively in the prognosis of psychistric illness, so it’s important to guarantee drug abstinence at least during hospitalization. This is even more significant in a medium stay unit because patients are more serious and resistant to treatment.In February 2003, a multidisciplinary group was formed to evaluate the situation of drug use in a psychiatric hospital and a drug screening protocol was then created.We evaluate if with the protocol, drug use decreases during hospitalization in a medium stay unit in a psychiatric hospital.Methods:We first compared drug use (positive results in urine samples) from 2000 to 2002 (before protocol: urine samples collected when there’s drug misuse suspicion) with the period after the protocol was enforced (from 2003 to 2006). Afterwards, we analyzed if drug use during hospitalization continues decreasing in 2007.In the protocol urine samples are collected when there’s a past misuse history, consumption suspicion, randomly and every time they leave for home.Results:It is proved that drug use decreases during hospitalization since the new protocol came into force. Drug use continues reducing since the enforcement of the drug screening protocol.Conclusion:The introduction and exhaustive completion of a protocol designed to decrease drug misuse in a psychiatric hospitalization unit, provokes a high reduction of drug use, and each year, the reduction of drug misuse is higher. So we think it’s convenient to generalize this kind of measures.

Aims:Comorbidity between drug misuse and mental disorders affects negatively in the prognosis of psychiatric illness, so it’s important to guarantee drug abstinence during hospitalization.The Hospital of Zamudio contains short and medium stay units. Patients are referred to medium stay units when disorders are more serious or the symptoms are resistant to treatment.In February 2003, a multidisciplinary group was formed to evaluate the situation of drug use in a psychiatric hospital and a drug screening protocol was then created.We evaluate if the enforcement of the protocol, has decreased drug use during hospitalization.Methods:It’s compared, retrospectively, drug use (positive results in urine samples) since the screening drug protocol was enforced (2003) to 2007. Urine samples are collected when there’s a past misuse history, consumption suspicion, randomly and every time the patient leave for home. It’s also compared the differences between short and medium stay units.Results:It’s proved that drug use decreases during hospitalization since the new protocol came into force in a medium stay unit. This drug protocol is not useful in a short stay unit.Conclusions:The introduction and completion of this protocol provokes a high reduction of drug use in a medium stay unit. This design seems not to be adequate to short stay units. Probably, collecting urine samples when patients came into a short unit gives false positive results because these patients don’t come from other hospitalization units as in the case of medium stay unit.