Importance of providing pharmaceutical care for patients using psychotropic medicines in community pharmacy

Mental health represents a major global public health challenge significantly impacting well-being, quality of life, and mortality. Psychotropic medicines are frequently associated with drug-related problems (DRPs) that may lead to decreased quality of life (QoL), falls, hospitalizations, and increased morbidity, or mortality. Non-adherence, observed in nearly half of patients with psychiatric disorders, remains a critical issue. This study evaluated the real-life impact of community pharmacists in identifying and managing DRPs among patients using psychotropic medicines and examines how sociodemographic factors influence QoL.

The randomized controlled study was conducted in six community pharmacies in the Istrian County (Croatia) among adult patients using psycholeptics or psychoanaleptics. DRPs were documented using the Pharmaceutical Care Network of Europe (PCNE) DRP Classification Version 9.1. QoL was assessed once, prior the intervention, with the WHOQoL-BREF Questionnaire. In the intervention group (A), pharmacists' intervention followed a standardized protocol, in contrast to common pharmacists' practice in Croatia provided to the participants in the control group (B).

Ninety-seven participants completed the study. Baseline measurement of QoL showed significantly higher scores in Physical health (p = 0.018) and Social interaction (p < 0.001) domains for younger (<65 years) and employed participants. The results of randomized intervention revealed higher median identified DRPs for older, unemployed or retired participants (p = 0.013; p = 0.018) in both groups. The most common manifested DRP was "untreated symptoms or indication," with significantly higher number of identified potential DRPs in group A (p = 0.015). "Adverse drug event" was the most frequent potential DRP with higher frequency in group A. "Lack of cooperation of patient" was the leading reason for unresolved DRPs in both groups.

Community pharmacists play an important role in identifying untreated conditions, adverse drug events and associated causes of DRPs related to psychotropic medicine use. Findings support integration of structured pharmaceutical care into community pharmacy practice to enhance patient safety through prevention of adverse drug events and medication safety surveillance.