Browsing by Subject "antidepressant"

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    Design and Implementation of Antidepressant Decision Making Aids
    (University of Minnesota, College of Pharmacy, 2012-07) DeJongh, Beth; Haight, Robert
    Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression. Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness. Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful. Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient’s medication adherence needs to be addressed in future studies.
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    Development of a Medication Monitoring System for an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) Team
    (University of Minnesota, College of Pharmacy, 2012-12) Watkins, Sarah C.; Winchester, Bruce R.; Brahm, Nancy C.
    Purpose: The primary goal was to improve medication management oversight for a severely mentally ill (SMI) community-based population by developing a medication monitoring system based on current guidelines to optimize pharmacotherapy and minimize potential medication-related adverse effects. The secondary goal was improvement in coordination of care between healthcare providers. Methods: Guidelines for medication used for psychiatric indications were reviewed. A database of medication for psychiatric indications with monitoring recommendation was developed. Results: Medication regimens for 68 members of the Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) program qualified for review. Fourteen medications, carbamazepine, chlorpromazine, clozapine, fluphenazine and fluphenazine long-acting injections (LAI), haloperidol and haloperidol LAI, lithium, lurasidone, olanzapine, paliperidone and paliperidone LAI, perphenazine, quetiapine, risperidone and risperidone LAI, valproic acid/divalproex, and ziprasidone, were identified. In total, 111 medications are used on a monthly basis. Each member receives more than one medication qualifying for review. Additional monitoring parameters that were evaluated included changes in laboratory orders for members with insulin-dependent diabetes. Annual lipid panels were changed to every 6 months, if applicable. Conclusions and Future Directions: This medication monitoring program was developed to help ensure IMPACT members receive the most effective care and minimize potential medication-related adverse effects. The secondary goal was to improve coordination of care. Medication monitoring will be added as a continuous quality assurance measure. Lab results will be reviewed at least monthly. The medication monitoring program will be evaluated annually.