Category: Federal Forum Posters
Purpose: Bipolar disorder and related disorders are chronic mental conditions that can present with a myriad of symptoms. They can be debilitating disorders causing significant psychosocial problems and comorbidities. Despite treatment standard of care being antiepileptics, evidence suggests these medications can contribute not only to comorbidities, but toxicity and side effects. Current practice guidelines recommend baseline and routine monitoring of laboratory values and serum drug concentrations. The objective of this project is to develop and implement a pharmacist managed psychotropic drug safety monitoring service to improve compliance with monitoring recommendations for patients receiving ongoing valproic acid derivatives and/or carbamazepine therapy.
Methods: Patients included in the psychotropic drug safety monitoring service are those that are receiving valproic acid derivatives and/or carbamazepine for bipolar and related disorders in an outpatient setting. The primary outcome of the study is change in completion rate of valproic acid and carbamazepine serum concentrations prior to and after service implementation. Secondary outcomes include comparison of pre-service and post-service completion rate of annual liver function tests, electrolytes, and complete blood count with differential for valproic acid and carbamazepine. Service personnel will assess compliance with laboratory monitoring, order recommended laboratory tests, contact patients about pending laboratory orders, provide recommendations to providers, and follow up with patients and providers when recommendations are made. Additionally, evaluation of laboratory monitoring that is ordered but not completed, number and types of recommendations made by the service personnel, and provider response to service recommendations will be completed. This study will exclude patients being treated for seizure disorders. All monitoring adheres to recommendations set forth in the Veterans Affairs/Department of Defense Clinical Practice Guidelines for Management of Bipolar Disorder.
Results: not applicable
Conclusion: not applicable
Brittany Spitznogle– PGY2 Psychiatric Pharmacy Resident, VA Western New York Healthcare System, Buffalo, NY