Abstract

THE CLINICAL EFFICACY AND SAFETY OF PSYCHO-PHARMACOLOGICAL TREATMENT OF PATIENTS WITH PSYCHIATRIC ILLNESS IN SOUTH INDIA: AN AMBISPECTIVE COHORT STUDY

Shangeetha S.*, Jemisha J., Pushparaj A., G. S. Jebish, Glady Gloria Grant C. J., Senthil Kumar N.

ABSTRACT

Aim: To evaluate the study from a multi-factor of perspective on the clinical efficacy, safety, and extrapyramidal side effects of psychopharmacological treatment in psychiatric in-patients by measuring patient's quality of life -WHO QOL BREF. Objective: To determine the prevalence of different psychiatric disorders in the general population. To investigate how co-morbid conditions affect the course of therapy. Comparing the effectiveness and safety of conventional and atypical antipsychotics. To encourage management to lower EPS through non-adherence measurement. To compare the pre-and post-score quality of life of patients. To evaluate the clinical pharmacist's contribution to providing psychiatric therapy. Methods: Between February and July 2022, an ambispective cohort research of individuals with mental disorders at several psychiatric hospitals was carried out. A chart review of the initial visit was done as part of the study's first phase. Using a predetermined paper-based questionnaire, baseline sociodemographic data and information on illness features, including age at onset, disorder type(s), relapse frequency, compliance with medication, and treatment history, were collected from medical records. The second stage of the study was conducted 2 months following the initial visit. Results: In this study, 250 psychiatric patients were enrolled, and all of them met the inclusion criteria. Partition treatment 1 (T1), which represents the patient using first-generation antipsychotics (FGAs), into two groups: treatment 2 (T2), which represents the patient taking second-generation antipsychotics, with each group having a total of 125 participants (SGAs). Patients were questioned on their current treatment status, the incidence of relapses in the last 3 weeks, adverse events (AEs), and quality of life (QoL). Among the total study population, 41.2% (103) were males and 58.2% (147) were females. The mean ± SD of about 40±15 was in age-wise distribution. the substance abuse distribution shows that 43% (67) of them were alcoholics. Among the population, the highest 2 to 5-year duration of illness is about 31.6% (79). The distribution of Hospitalization Day status shows that the highest population had only short stay, about 85.6% (214) and 14.4% (36) of people show long stay hospitalization. This study shows that the highest prevalence of schizophrenia is about 71, males (30) and females (41) as well the prevalence of co-morbidity among psychiatric illnesses is highest in Diabetes about 28% (25) and 25% (22) were hypertensive. Among the T1 and T2 populations, the highest population is about 58.4% (73) T1 shows on non-Adherence. Patients whose T2 has minimal non-Adherence 20% (25). Extrapyramidal side effects were observed higher in the first generation of antipsychotics (FGAs) compared to (SGAs). But in this study, we observed that the patients who receive second-generation antipsychotics (SGAs) are likely to have metabolic symptoms which as weight gain seen higher among the population. WHOQOL BREF was used to measure patients’ quality of life including four domains. Conclusion: The study's findings suggest that first-generation antipsychotics (conventional/typical) FGAs are more effective but also more likely to cause extrapyramidal side effects, whereas second-generation antipsychotics (atypical) are less effective than FGAs but also less likely to cause extrapyramidal side effects. Additionally, patients who received SGAs reported compliance with metabolic symptoms. In this study, short-term hospitalization shows effectiveness as compared to long-term hospitalization. Quality of life eventfully improved in post score and SGAs receiving patient T2 shows better QOL according to our research study. In this study, we provided 50 clinical pharmacist recommendations, most commonly dose adjustment, medication initiation, medication discontinuation, and other interventions.

Keywords: Psychopharmacological, psychiatric, extrapyramidal side-effects, quality of life.