The role of pharmacists in multidisciplinary home medication review services for psychiatric patients at Hospital Kuala Lumpur

OBJECTIVES: Home medication review (HMR) by pharmacists plays an important role in ensuring appropriate medications are used and enhancing adherence among patients with serious mental illnesses. This study aimed to evaluate the role of HMR pharmacists in identifying drug-related problems (DRPs), adverse effects encountered and medication adherence among psychiatric patients. METHODS: A retrospective, observational study was conducted to gather HMR reports from psychiatry HMR services in Hospital Kuala Lumpur from 1 September 2023 to 31 August 2024. RESULTS: The most frequent DRP identified were patient-related causes, in which 47.2% of them intentionally consumed medications less than prescribed and 13.7% had no or inappropriate outcome monitoring. 21.2% and 16.3% of them reported hypersalivation and oversedation, respectively, as the main adverse drug events. Among different prescribed treatment regimens, those prescribed with a combination of oral and long-acting injectable (LAI) medications showed the poorest adherence rate (50.4%), followed by oral medications only (33.3%) and LAI only (10.6%). CONCLUSIONS: Suboptimal drug treatment and hypersalivation were the most common DRPs identified while poor adherence to combined oral and LAI were the most prevalent problem in patients with SMI. Pharmacists should actively review medication regimen during HMR visits to recognize DRPs and improve adherence.