Potential drug-drug interactions in outpatients with depression of a psychiatry department

Chen, Yang; Ding, Lei

doi:10.1016/j.jsps.2022.12.004

Cited by 6 publications

(3 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both the patients and the clinicians reported a better understanding and management of mental health medications, validating the effectiveness of the strategies employed. Furthermore, the long-term feasibility and sustainability of these changes were confirmed, highlighting the potential for these practices to be integrated into routine clinical care [19,20].…”

Section: Outcomementioning

confidence: 88%

“…Post the initial clinical review, 54 of these patients were able to attribute a portion of their presenting symptoms to their mental health polypharmacy regimen. These included headaches (18), nausea (6), dizzy spells (7), fatigue (12), abdominal pain (4), myalgia (7), arthralgia (9), back pain ( 14), weight gain (22), skin reactions (8), worsening anxiety ( 16), and sleep disturbances (19).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Mental Health Polypharmacy in “Non-Coded” Primary Care Patients: The Effect of Deprescribing

Jerjes,

Ramsay,

Stevenson

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Mental health (MH) polypharmacy, defined as prescribing multiple mental health medications for the same condition, presents significant challenges in clinical practice. With varying prevalence rates and an increasing trend, particularly in the UK, this deprescribing prospective quality improvement project aimed to address the complexities and risks associated with MH polypharmacy. Patients and Methods: A large primary care centre in London was selected for this project. Electronic records of 667 patients (non-coded in mental health lists) were analysed as a result of the absence of a Systematised Nomenclature of Medicine Clinical Terms (SNOMED CT) for mental health. Seventy-two non-coded patients exhibiting “same-class” as well as “adjunctive” and “augmentation” polypharmacy were identified. Their demographic and health data, including MH diagnoses, physical status, and lifestyle habits, were evaluated. This deprescribing prospective project included 68 patients and employed a model inspired by the Plan–Do–Study–Act (PDSA) cycle, focusing on reducing psychotropic, adjunctive, and augmentative medications while monitoring mental health control through face-to-face consultations using the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Assessment-7 (GAD-7) scores, alongside physical health parameters. Results: The project revealed a significant decrease in the average number of psychotropic and adjunct medications from initial consultations to the end of the 18-month period. Additionally, a marked reduction in reported side effects and drug interactions was observed. Improvements in mental health control, as evidenced by PHQ-9 and GAD-7 scores, were noted. Physical health parameters, including BMI, blood pressure, heart rate, HbA1c, and cholesterol levels, also showed significant improvements. Educational initiatives for patients and clinicians were successfully implemented, contributing to these positive outcomes. Discussion: The project faced challenges like balancing medication reduction with mental health stability, patient apprehension, and the absence of standardised protocols. However, the successful reduction in medication numbers and the improvement in health outcomes highlight the effectiveness of the model. This project underscores the necessity of a tailored approach to MH polypharmacy, emphasising continuous education, clinical titration, and adherence to guidelines. Future research is needed to develop clear guidelines for medication combination in mental health care and to understand the long-term effects of polypharmacy in mental health populations. Conclusions: This project demonstrates the potential for significant improvements in the management of MH polypharmacy. By carefully managing medication reductions and employing a comprehensive care approach, including patient education and clinician training, the project achieved improvements in both mental and physical health outcomes. These findings suggest a promising direction for future practices in MH polypharmacy management.

show abstract

Section: Outcomementioning

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Mental Health Polypharmacy in “Non-Coded” Primary Care Patients: The Effect of Deprescribing

Jerjes,

Ramsay,

Stevenson

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…Over the past decade, the prevalence of pDDI in outpatients has increased, ranging from 16% to 91% ( 23 ). Discrepancies in the prevalence of pDDI may be attributed to differences in study population, study design, and DDI screening instruments ( 24 ). Recent studies conducted in patients with hypercholesterolemia showed that at least one pDDI was detected in 45% and 83.3% of patients, respectively ( 9 , 10 ), which is less compared with the results of our study in which the same was detected in 98.1% of subjects.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Potential Drug-Drug Interactions in Outpatients with Dyslipidemia

Lalatovic

Pantović

Nedović-Vuković³

et al. 2023

ijph

View full text Add to dashboard Cite

Background: Patients with dyslipidemia are usually multimorbid and require polypharmacy. Therefore, it is important to identify potential drug-drug interactions (pDDIs) in time to prevent their consequences. We aimed to identify and analyze risk factors contributing to their occurrence to guide health professionals. Methods: A prospective cross-sectional study of 216 outpatients with dyslipidemia was conducted from May 2021 to April 2022 in Podgorica, the capital of Montenegro. pDDIs were identified using Medscape, Epocra- tes, and Drugs online interaction checkers. Multivariate regression analysis was performed to evaluate the po- tential predictors of interactions. Results: pDDIs were detected in 212 (98.1%) participants, whereas pDDIs with high clinical significance were detected in 25.46%, 40.74%, and 58.8% of subjects by Drugs, Epocrates, and Medscape, respectively. Polypharmacy emerged as a risk factor for the occurrence of pDDIs in all three checkers in each category of clinical significance. The use of non-steroidal anti-inflammatory drugs and antiplatelet drugs contributes to the incidence of severe pDDIs B=1.014, 95%CI 0.681-1.346, P=0.000 and B=0.492, 95%CI 0.286-0.698, P=0.000, by Epocrates and Medscape respectively. The number of prescribers per patient was a protective factor against moderate pDDI B= -0.858, 95%CI -1.572-(-0.144), P=0.019 and B= -0.956, 95%CI -1.671-(- 0.241), P=0.009, by Medscape and Epocrates, respectively, but a risk factor for the occurrence of minor pDDIs B=0.373, 95%CI 0.033-0.712 P=0.032 and B=0.143, 95%CI 0.042-0.244, P=0.006, by the same checkers. Conclusion: Knowledge of the risk factors contributing to the occurrence of pDDIs is important for the development and implementation of strategies for their prevention, and given the high prevalence of dyslipidemia, understanding these factors seems crucial nowadays.

show abstract

Incidence and risk factors for potential drug-drug interactions in outpatients receiving opioid analgesics

Chu,

Yao,

Gao

et al. 2024

Expert Opinion on Drug Safety

View full text Add to dashboard Cite

Potential drug-drug interactions in outpatients with depression of a psychiatry department

Cited by 6 publications

References 46 publications

Mental Health Polypharmacy in “Non-Coded” Primary Care Patients: The Effect of Deprescribing

Mental Health Polypharmacy in “Non-Coded” Primary Care Patients: The Effect of Deprescribing

Risk Factors for Potential Drug-Drug Interactions in Outpatients with Dyslipidemia

Incidence and risk factors for potential drug-drug interactions in outpatients receiving opioid analgesics

Contact Info

Product

Resources

About