Assessing The Prevalence And Severity Of Potential Drug-drug Interactions Among Mentally Ill Inpatients

Abstract

Mental health refers to a wider range of activities directly or indirectly related to the mental well-being. Mentally ill patients in Kenya are increasingly becoming prone to a high risk of polypharmacy, complex therapeutic regimen and frequent modification of therapy. The objective of this study was to assess the prevalence and severity of potential drug-drug interactions among mentally ill patients admitted at Mathari Mental Hospital in Nairobi County, Kenya. The study was designed in a retrospective descriptive cross-sectional study of medical records data of patients who had undergone mental treatment and were admitted at Mathari Mental Hospital between July and December 2013. This study focused on a population comprising of all mentally ill patients who were admitted and put on medication during the study period of either gender and ageing between 13 to 75 years. One hundred and seventy five patient files were sampled, married and unemployed patients had a statistically significant (p<0.05) association with a prevalence and severity of potentially serious drug interactions. Participants with bipolar mood disorder had a statistically significant association with potentially serious drug interactions [OR 4.39 CI (1.09, 17.46) p = 0.04]. There was a statistically significant association of potentially serious drug interactions with fluphenazine [OR 10.38 CI (4.66, 23.10) p<0.01) haloperidol [OR 4.39 CI (2.29, 8.41) p<0.01] and amitriptyline [OR 3.39 CI (1.36, 8.41) p=0.01]. Married, unemployed and patients on fluphenazine, haloperidol, amitriptyline and chlorpromazine were at a higher risk of having potentially serious drug-drug interactions. These drugs exhibited both pharmacodynamic and pharmacokinetic drug interaction mechanisms. We recommend continuous electrocardiogram for patients on specific antipsychotics like haloperidol.