Assessment of Contributing Factors and Treatment Practices for Therapeutic Efficacy and Drug-Related Problems in Suicidal Psychotic Patients.

Bibliographic Details
Title:	Assessment of Contributing Factors and Treatment Practices for Therapeutic Efficacy and Drug-Related Problems in Suicidal Psychotic Patients.
Authors:	Shahzad S; Department of Pharmacy, University of Peshawar, Peshawar 25120, Pakistan., Ullah S; Department of Pharmacy, University of Peshawar, Peshawar 25120, Pakistan., Nazar Z; Department of Psychiatry, Medical Teaching Institute Lady Reading Hospital, Peshawar 25120, Pakistan., Riaz M; Shafique Psychiatric Clinic, Peshawar 25120, Pakistan., Khuda F; Department of Pharmacy, University of Peshawar, Peshawar 25120, Pakistan., Khalil AAK; Department of Biological Sciences, National University of Medical Sciences, Rawalpindi 46000, Pakistan., Almutairi MH; Department of Zoology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia., Sayed AA; Zoology Department, Faculty of Science, Cairo University, Giza 12613, Egypt., Büyüker SM; Department of Pharmacy Services, Üsküdar University, İstanbul 34664, Turkey., Khan N; Department of Biochemistry, Boston University School of Medicine, Boston University, Boston, MA 02118, USA.
Source:	Brain sciences [Brain Sci] 2022 Apr 25; Vol. 12 (5). Date of Electronic Publication: 2022 Apr 25.
Publication Type:	Journal Article
Language:	English
Journal Info:	Publisher: MDPI Country of Publication: Switzerland NLM ID: 101598646 Publication Model: Electronic Cited Medium: Print ISSN: 2076-3425 (Print) Linking ISSN: 20763425 NLM ISO Abbreviation: Brain Sci Subsets: PubMed not MEDLINE
Imprint Name(s):	Original Publication: Basel, Switzerland : MDPI
Abstract:	Suicide, a deliberate act of self-harm with the intention to die, is an emerging health concern but, unfortunately, the most under-researched subject in Pakistan, especially in Khyber Pukhtunkhwa (KPK). In this study, we aimed to identify risk factors that can be associated with suicidal behavior (SB) and to evaluate the prevailing treatment practices for therapeutic efficacy and drug-related problems (DRPs) in psychotic patients among the local population of KPK. A prospective, multicenter study was conducted for suicidal cases admitted to the study centers by randomized sampling. Socio-demographics and data on suicidal behavior were assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS), socioeconomic condition by Kuppuswamy socioeconomic scale (KSES) and treatment adherence by Morisky Medication-Taking Adherence Scale (MMAS-4). Drug-related problems and the therapeutic efficacy of prevailing treatment practices were assessed at baseline and follow-up after 3 months of treatment provided. Regarding suicidality (N = 128), females reported more ideations (63.1%), while males witnessed more suicidal behavior (66.6%, p < 0.001). Suicide attempters were mostly married (55.6%, p < 0.002); highly educated (53.9%, p = 0.004); dissatisfied with their life and had a previous history (p < 0.5) of suicide attempt (SA) (20.6%), self-injurious behavior (SIB) (39.7%) and interrupted (IA) or aborted attempts (AA) (22.2%). A greater improvement was observed in patients receiving combination therapy (p = 0.001) than pharmacotherapy (p = 0.006) or psychotherapy (p = 0.183), alone. DRPs were also detected, including drug-selection problems (17.88%), dose-related problems (20.64%), potential drug−drug interactions (24.31%), adverse drug reactions (11.46%) and other problems like inadequate education and counseling (21.55%). Furthermore, it was also found that psychotic patients with suicidal ideations (SI) were significantly (p = 0.01) more adherent to the treatment as compared to those with suicidal attempts. We concluded that suicide attempters differed significantly from patients with suicidal ideations in psychotic patients and presented with peculiar characteristics regarding socio-demographic factors. A combination of therapies and adherence to the treatment provided better outcomes, and targeted interventions are warranted to address drug-related problems.
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Contributed Indexing:	Keywords: Pakistani population; contributing factors; drug-related problems; psychotic patients; suicidal behavior; suicidal ideations; therapeutic efficacy
Entry Date(s):	Date Created: 20220528 Latest Revision: 20230308
Update Code:	20230309
PubMed Central ID:	PMC9138544
DOI:	10.3390/brainsci12050543
PMID:	35624930
Database:	MEDLINE
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ISSN:	2076-3425
DOI:	10.3390/brainsci12050543