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The impact of a pharmacist assisted clinic upon medication adherence and quality of life in mental health patients
Lizer MH,Parnapy Jawaid SA,Marsh W,Mogili L
Pharmacy Practice (Granada) , 2011,
Abstract: Objectives: To determine if a pharmacist assisted psychiatric clinic would improve adherence to medications and quality of life over 6 months. The primary study endpoints were the change from baseline in Medication Adherence Rating Scale (MARS), Brief Evaluation of Medication Influences and Beliefs (BEMIB), World Health Organization Quality of Life - BREF (WHOQOL-BREF) scales as well as hospitalizations and emergency room visits. Secondary endpoints included metabolic and physiologic parameters.Methods: A prospective, single-center study conducted at an outpatient psychiatric clinic. Subjects were required to attend 3 clinic visits (baseline, 3 and 6 months) with the pharmacist. Subject and medication histories were obtained at each visit. Subjects’ records within the local health system were reviewed for emergency room visits and hospitalizations. Metabolic parameters were assessed at each visit.Results: Twenty-seven subjects enrolled and twenty subjects completed. Total MARS score at baseline and study end were 7.90 and 8.65, respectively. At baseline, 10 (50%) were nonadherent based on the BEMIB and 9 (45%) were nonadherent at 6 months. Statistically significant improvements were seen in 2 domains of the WHOQOL-BREF. Reductions in both ER visits and hospitalizations were achieved. There were significant improvements in total cholesterol and LDL.Conclusions: Improvements were seen in two domains of the WHOQOL-BREF – physical capacity and psychological well-being over the 6 month period. While improvements were seen in various rating scales, due to small sample sizes, these were insignificant improvements. Reductions in hospitalizations and ER visits were also seen during the study and up to 6 months post study. Statistically significant improvements were also seen in both total cholesterol and LDL. The lack of improvement in many of the study outcomes reflects the difficulty of the mental health population to adhere to treatment recommendations; but also underscores the need for continued research in this area. This pilot demonstrates the pharmacist’s ability to provide comprehensive medication management services to the psychiatric outpatient.
Evaluation of Genetic Variations in Organic Cationic Transporter 3 in Depressed and Nondepressed Subjects
Nina Hengen,Mitsi H. Lizer,Robert S. Kidd
ISRN Pharmacology , 2011, DOI: 10.5402/2011/161740
Abstract: Organic cationic transporter 3 (OCT3, SLS22A3) has only recently emerged as one of the regulators of monoaminergic neurotransmission, which plays a critical role in the pathogenesis of depression and is a potential new antidepressant drug target. OCT3 single-nucleotide polymorphisms (SNPs) have been investigated for their association with psychiatric disorders such as methamphetamine use disorder and obsessive-compulsive disorder in children and adolescents, but not depression. This study was designed to evaluate the allele frequencies of seven OCT3 SNPs in a US Caucasian depressed population and compare these frequencies with a control group of nondepressed subjects. Informed consent and a DNA sample were obtained from 157 subjects and analysis was performed using real-time PCR. Allele and genotype frequencies were compared using a t-test and the Pearson chi-square analysis, respectively. There were no significant differences in OCT3 allele or genotype frequencies between the depressed and non-depressed groups for all seven SNPs evaluated. 1. Introduction Depression affects up to 20% of the world population and is one of the top ten causes of morbidity and mortality worldwide [1]. Even though the precise neurobiological processes causing depression are not yet completely understood, it is certain that monoamine neurotransmission plays an important role [2], as the vast majority of currently available antidepressants alter serotonergic, noradrenergic, and/or dopaminergic neurotransmission [3]. Monoamine neurotransmission is regulated by the synaptic levels of neurotransmitters serotonin (5-HT), norepinephrine (NE), and dopamine (DA). These levels are, in turn, determined by the activity of monoamine transporters [4]. Two uptake mechanisms are responsible for removal of synaptic monoamines. The high-affinity, low-capacity, substrate-specific, and Na+- and Cl?-dependent system consists of serotonin (SERT), norepinephrine (NET), and dopamine (DAT) transporters [4–6]. On the other hand, a low-affinity, high-capacity, multispecific, and Na+- and Cl?-independent system includes organic cation transporters (OCT) 1, 2, and 3 (also known as solute carrier family 22 members 1–3, (SLC22A)1–3) [7]. All three OCTs are capable of transporting multiple endogenous and exogenous organic cations, including neurotransmitters 5-HT, NE, epinephrine, DA, and histamine [7]. OCTs show a broad tissue distribution, with expression in the CNS and peripheral tissues in both humans and rodents [7]. While all three OCT subtypes are expressed in the brain [7], OCT3 is preferentially
The impact of a pharmacist assisted clinic upon medication adherence and quality of life in mental health patients
Lizer,Mitsi H.; Parnapy Jawaid,Sarah A.; Marsh,Wallace; Mogili,Lakuma;
Pharmacy Practice (Internet) , 2011, DOI: 10.4321/S1886-36552011000300002
Abstract: objectives: to determine if a pharmacist assisted psychiatric clinic would improve adherence to medications and quality of life over 6 months. the primary study endpoints were the change from baseline in medication adherence rating scale (mars), brief evaluation of medication influences and beliefs (bemib), world health organization quality of life - bref (whoqol-bref) scales as well as hospitalizations and emergency room visits. secondary endpoints included metabolic and physiologic parameters. methods: a prospective, single-center study conducted at an outpatient psychiatric clinic. subjects were required to attend 3 clinic visits (baseline, 3 and 6 months) with the pharmacist. subject and medication histories were obtained at each visit. subjects′ records within the local health system were reviewed for emergency room visits and hospitalizations. metabolic parameters were assessed at each visit. results: twenty-seven subjects enrolled and twenty subjects completed. total mars score at baseline and study end were 7.90 and 8.65, respectively. at baseline, 10 (50%) were nonadherent based on the bemib and 9 (45%) were nonadherent at 6 months. statistically significant improvements were seen in 2 domains of the whoqol-bref. reductions in both er visits and hospitalizations were achieved. there were significant improvements in total cholesterol and ldl. conclusions: improvements were seen in two domains of the whoqol-bref - physical capacity and psychological well-being over the 6 month period. while improvements were seen in various rating scales, due to small sample sizes, these were insignificant improvements. reductions in hospitalizations and er visits were also seen during the study and up to 6 months post study. statistically significant improvements were also seen in both total cholesterol and ldl. the lack of improvement in many of the study outcomes reflects the difficulty of the mental health population to adhere to treatment recommendations; but also unders
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