Effects of Pharmacist Drug Regimen Reviews on Physicians' Compliance with Recommended Laboratory Monitoring Criteria for Psychotropic Medications at a State Supported Living Center

Purpose: Individuals that reside in state supported living centers for the developmental disabled and mentally impaired can be on a myriad of psychotropic medications to treat their disturbances. Appropriate and timely laboratory tests must be performed on all psychotropic medications to determine therapeutic levels for effectiveness and identify toxicities. It has been shown that failure to monitor drug therapy is among one of the most frequent causes of preventable adverse drug events. The errors that are associated with laboratory monitoring to generally tend to occur when there is a lack of baseline or follow-up laboratory work, or a delay in actions being taken to address abnormal lab results. The objective of this study is to determine if a pharmacist performing quarterly drug regimen reviews at a state supported living center can improve the compliance rate as it relates to meeting laboratory monitoring parameters for psychotropic medications.

Methods: All the necessary forms were submitted to the Texas Department of State Health Services Mental Health and Mental Retardation Research Administration Institutional Review Board #2 in Austin, Texas for review and approval. A retrospective chart review was performed on 50 residents at the Lufkin State Supported Living Center with an Axis I diagnosis of a psychotic disorder, bipolar disorder, or autism and Axis II diagnosis of mental retardation.

Results: The performance of a quarterly drug regimen review by a pharmacist increased the likelihood of appropriate labs being done for individuals on psychotropic medications. From the fifty charts that were reviewed, residents who received the pharmacists’ reviews (75%) had the recommended labs performed.

Conclusion: The results of this chart review will determine if a pharmacist’s recommendations for appropriate laboratory monitoring of psychotropic medications can be instrumental in assessing for effectiveness of psychotropic medication therapy and minimizing the development of adverse drug events or potential toxicities.