Community pharmacists improved the quality of psychopharmacology prescribing by reducing the total number of drugs prescribed, according to a retrospective study from Slovenia.

The study included 246 patients aged 65 years or older who received at least 10 medications, including at least one psychotropic. Of the 3,294 medications prescribed, 14.6 per cent were psychotropics. Patients received a mean of 13.4 medications.

Almost one in 10 (9.5 per cent) prescribed medications were potentially inappropriate and 77.6 per cent of patients received at least one potentially inappropriate medication (PIM). Researchers identified 71 potential drug-drug interactions (DDIs). A fifth of patients (21.1 per cent) had at least one potential DDI. 

Pharmacists proposed 374 interventions regarding psychopharmacology, usually drug discontinuations (61.5 per cent), drug initiations (28.6 per cent) and dose adjustments (10.9 per cent). 

GPs accepted 45.2 per cent of the suggested interventions, which reduced the average number of medications taken by each patient by 7.5 per cent (13.4 to 12.4), PIMs by 21.8 per cent (312 to 244) and DDIs by 54.9 per cent (71 to 31).

Adherence to treatment guidelines for antidepressants and antipsychotics also improved. Treatment that did not follow guidelines fell from 49.6 to 24.8 per cent following a pharmacist’s review.

The review also reduced the proportion of people in whom antipsychotic guidelines were not being followed from 50.6 to 35.7 per cent.

(Scientific Reports 2022; 12:11387)