Clinical pharmacist assessment in monitoring and resolving the adverse drug reaction in bipolar disorder patients: A prospective, observational study at tertiary care teaching hospital

Abstract

BACKGROUND: Adverse drug reaction (ADR) is a noxious, unintended effect of the drug which may occur due to pharmacotherapy of the disease. Bipolar disorder is a chronic mental illness represented by mania, depression and cyclic episode. The treatment of Bipolar disorder is lifelong. Hence, there are increased chances of ADRs. METHODOLOGY: An observational, prospective study was performed on 286 patients, to identify, monitor, and resolve the ADR with bipolar disorder patients. The patients aged 18–65 years of either gender or diagnosed with bipolar disorder were enrolled in the study. Patient-related data had been collected from the patient record; probability of ADR was measured by Naranjo scale and severity by Hartwig scale. Descriptive statistics had been used for study data interpretation. RESULTS: A total of 286 patients were enrolled in the study, of which 27 patients suspected with ADR. Among all the ADR, nonallergic side effect suffered ADR were 88.1%. Of which, the most common ADR were hand tremor and hypothyroidism, which were associated with lithium (81.4%) followed by valproate (11.1%). On causality assessment, 44.4% cases were probable and possible. In most cases, severity of ADR was founded at Level III with 74.7% and Level II with 25.9%. The rate of acceptance of pharmacist intervention by a psychiatrist has been found to be 74.7%. The major cause of ADR was a drug/dose selection (74.07%). CONCLUSION: ADRs occur most frequently in bipolar disorder. The incidence of drug-related noxious effect can be minimized by the prior identification, monitoring, and reporting. Thus, the clinical pharmacist can play a key role in pharmacovigilance of ADR.