Effectiveness of Pharmaceutical Care at Schizophrenia Clinic in Psychiatric Hospital

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Chakri Kaeokumbong
Aporanee Chaiyakum


Introduction: In schizophrenia, medication adherence is importance to control and prevent relapse rate. Pharmaceutical care is a service that improve medication adherence. Method: A Single-blinded, randomized, controlled clinical trial was performed in schizophrenia outpatient clinic at Nakhon Ratchasima Rajanagarindra psychiatric hospital. This study was conducted during 1 February – 31 July 2014. The objective of this study was to examine the outcomes of pharmaceutical care in patients with schizophrenia by Mental Health Gap Action Programme for Schizophrenia (mhGAP) by compare medication adherence, relapse rate and quality of life between study group and control group. The samples were divided into 2 groups, 50 patients each in the study and control group. At the end of the study 44 patients in the study group and 45 patients in the control group were remained for analysis. Result: The medication adherent patients in the study group were more than the control group (80.95% and 38.23%; p<0.001). The mean score of psychotic symptom by Brief Psychiatric Rating Scale (BPRS) in the study group was less than the control group (24.00±10.25 and 28.00±11.00; p=0.012). The relapse rate of psychotic symptom in the study group was statistical significant lower than the control group (4.36% and 13.62%; p<0.001).The mean score of quality of life by WHOQOL- BREF-THAI 26 in the study group was statistical significant higher than the control group (74.50± 13.53 and 65.29±11.53; p=0.002). Drug related problems (DRPs) in study group decreased 27.97%, but increased 15.08% in the control group. Conclusion: Pharmaceutical care by mhGAP program in patients with schizophrenia increased medication adherence decreased DRPs and psychotic severity. The quality of life could not be determined in this study since we did not do full program of mhGAP.


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Schizophrenia. National Institute of Mental Health online] 2013[cited 2013 July 20]. Available from: http://www.nimh.nih.gov/statistics/1SCHIZ.shtml.

Schizophrenia. World Health Organization [online] 2013[cited 2013 Jul 20]. Available from: http://www.who.int/mental_health/management/schizophrenia/en/.

Number and incidence schizophrenia patient Thailand in finical years 2011. Plan division department of mental health, Ministry of Public Health, Public Health [Online] 2011 [cited 20 Jul 2013]. Available from: http://www.plan.dmh.go.th/forums/index.php?topic=746msg799#msg799.

Stat finical year data 2011. Nakhon Ratchasima Rajanagarindra psychiatric hospital [Online] 2011[cited 20 Jul 2013]. Available from: http://www.jvkorat.go.th/newsite/%5Cstatistics%5CIPD%5.

Crismon ML, Argo TR and Buckley PF. Schizophrenia. In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG and Posey LM (Editors). Pharmacotherapy: A Pathophysiologic Approach.7th ed. New York: McGraw-Hill Companies, Inc.; 2005.1099-120.

Maneesakorn S, Robson D, Gournay K and Gray R. An RCT of adherence therapy for people with schizophrenia in Chiang Mai, Thailand. J Clin Nurs. 2007 Jul; 16(7):1302-12.

mhGAP Intervention Guide. World Health Organization [Online] 2011 [cited 20 Jul 2013]. Available from: http://www.who.int/mental_health/publications/mhGAP_intervention_guide/en/

World Health Organization. mhGAP: Mental Health Gap Action Programme: scaling up care for mental, neurological and substance use disorders. Geneva, Switzerland, World Health Organization, 2008.

Wittes J. Sample size calculation for randomized controlled trials. Epidemilol Rev 2002; 24(1):39-53

Valenstein M, Kavanagh J, Lee T and et al. Using A Pharmacy-Based Intervention To Improve Antipsychotic Adherence Among Patients With Serious Mental Illness. Schizophr Bull 2009; 37(4):727-36.

Department of mentalhealth, Ministry of Public Health, Public Health. The mhGAP Implementation Program for Psychosis: Practical Manual 2011-2012).

Try volume 2011-2012; 1: Bangkok. Somdet Chaopraya Institute of Psychiatry; 2011.

Grymonpre RE, Didur CD, Montgomery PR, Sitar DS. Pill count, self-report, and pharmacy claims data to measure medication adherence in the elderly. Ann Pharmacother1998; 32(7-8):749-54.
Eaddy M, Grogg A and Locldear J. Assessment of Compliance with Antipsychotic Treatment and Resource Utilization in a Medicaid Population. Clin Ther 2005; 27(2):263-72.

Sakthong P, Chabunthom R and Charoenvisuthiwongs R. Psychometric properties of the Thai version of the 8-item Morisky Medication Adherence Scale in patients with type 2 diabetes. Ann Pharmacother 2009; 43(5): 950-7.

Almond S, Knapp M, Francois C, Toumi M and Brugha T. Relapse in schizophrenia: costs, clinical outcomes and quality of life. British Journal of Psychiatry 2004; 184(1):346-51.

Suzuki K, Awata S, Takano T, Ebina Y, Shindo T, Harada N and Matsuoka H. Adjusting the frequency of continuation and maintenance electroconvulsive therapy to prevent relapse of catatonic schizophrenia in middle-aged and elderly patients who are relapse-prone. Psychiatry Clin Neurosci 2006; 60(4):486-92.

Mahuntnirunkul S, Silapakit P, Poompaisarnchai W. Quality of life of people thai in critical economy. J Ment Health Thai 1998; 5(3): 4-15.

Kenkratoke J, Kanjanasilp, Leelathanaroek and Dudsadeeprasert J. Effect of pharmaceutical care in patients with schizophrenia and drug counseling for caregivers at Nakhon Ratchasima Rajanagarindra psychiatric hospital. JNRRPH 2011; 11(3):40-50.

Gumley A, O’Grady M, Mcnay L, Reilly J, Power K and Norrie J. Early intervention for relapse in schizophrenia: results of a 12-month randomized controlled trial of cognitive behavioural therapy. Psychol Med 2003; 33(3): 419–431.

Herz MI, Lamberti JS, Mintz J, Scott R, O'Dell SP, McCartan L and Nix G. A program for relapse prevention in schizophrenia: a controlled study. Arch Gen Psychiatry 2000; 57(3):277-83.

Onsombat W, Kanjanasilp and Leelathanalerk. Outcomes of Pharmaceutical Care in Schizophrenic Outpatients on Antipsychotics Adherence in Khonkean Rajanagarindra P sychiatric Hospital. J Sci Techno MSU 2011; 30(1): 62-73.