Pharmacist-designed and -implemented pharmaceutical care plan for antipsychotic-induced movement disorders.
We developed a systematic approach to assess the presence, severity, and management of extrapyramidal symptoms (EPS) in patients treated with antipsychotics. Patients were evaluated by the Modified Simpson-Angus scale, Abnormal Involuntary Movement Scale, and Dyskinesia Identification System: Condensed User Scale. We completed 235 sets of evaluations in 83 patients. A pharmaceutical intervention was proposed in 54% (130) of evaluations, of which 82% (107) were accepted and followed. In 93% (99) evaluations in which a recommendation was followed, clinical outcome was positive. The most common intervention was reducing the dosage or discontinuing the antidyskinetic agent, most often an anticholinergic (55% of cases). Our results show that detailed monitoring of EPS in a clinical pharmacist-operated clinic promotes rational drug therapy, limits unnecessary drugs, and improves clinical outcome of patients with EPS.
Stoner
S C
SC
Division of Pharmacy Practice, School of Pharmacy, University of Missouri-Kansas City, 64108-2741, USA.
Worrel
J A
JA
Jones
M T
MT
Farrar
C A
CA
Ramlatchman
L V
LV
D000465:Algorithms; D014150:Antipsychotic Agents / Q000009:adverse effects*; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D009069:Movement Disorders / Q000188:drug therapy*; D009127:Muscle Rigidity / Q000139:chemically induced*; D010595:Pharmacists
D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists