Assessment of Drug Use Pattern Among Patients Visiting Ambulatory Patient Education Centre of a Tertiary Care Hospital

Background: Drug-Related Problems (DRPs) are widespread in psychiatric care due to complex pharmacotherapy, polypharmacy, and coexisting conditions. The chronic nature of mental diseases frequently necessitates long-term medication, raising the risk of DRPs such as ADRs, interactions, and incorrect dose. These concerns can result in longer hospital stays, increased morbidity, and higher healthcare expenses. DRPs are defined by the Pharmaceutical Care Network Europe as events that prevent desirable health outcomes from occurring. Clinical pharmacists play an important role in recognizing, preventing, and managing DRPs to improve patient safety and therapeutic efficacy. Objective: The aim of this study was to determine the incidence and types of drug-related problems (DRPs) among psychiatric patients. Specific objectives included assessing drug use using WHO prescribing indicators, looking into the kind and prevalence of DRPs and ADRs, and identifying important risk factors. The goal was to increase pharmaceutical safety while maximizing therapeutic efficacy. Methodology: A prospective interventional study was carried out over nine months in the psychiatry department of JSS Hospital in Mysuru. Patients admitted to the psychiatric ward and on at least two drugs were included. the required data including the patient's socio demographic details, medical history, present illness, were gathered from treatment chart, patient interviews, and interactions with healthcare providers were done. DRPs were classified using the Hepler and Strand categorization approach. Adverse drug responses (ADRs) were evaluated using the WHO-UMC causality assessment and Naranjo’s procedure. Lexicomp (UpToDate) was used to examine drug interactions and categorize them according to their severity. Drug use patterns were assessed using WHO core prescription indicators. Result: Of the 228 participants, 73.6% were male, and the most common age group was 31-40 years (42%). Comorbid conditions were found in 25.87% of patients, with hypertension and diabetes being the most prevalent. A total of 1,777 drugs were prescribed, with an average of 7.79 drugs per patient, indicating significant polypharmacy. Only 8.8% of drugs were prescribed by generic name, and 76.47% were from the Essential Drug List. A total of 265 DRPs were identified, the most frequent being drug-drug interactions (58.86%), untreated indications (13.2%), and ADRs (9.81%). ADRs were primarily associated with antipsychotics and benzodiazepines, with constipation being the most reported reaction. DRPs were significantly associated with comorbidities (p