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TOPLINE:
Implementing physician-led medication reviews through interdisciplinary dialogue could reduce the number of prescribed drugs and potentially inappropriate prescriptions in patients with diabetes and severe mental disorders, without worsening psychiatric symptoms.
METHODOLOGY:
- Patients with both diabetes and severe mental disorders may experience inappropriate polypharmacy, which increases their risk for side effects and drug interactions.
- Researchers conducted this trial to examine whether implementing physician-led medication reviews through interdisciplinary dialogue can improve medication patterns and clinical outcomes in patients with diabetes and severe mental disorders.
- A total of 52 patients (median age, 54 years) with diabetes and severe mental disorders were included and randomly assigned to either an intervention group (n = 26), in which the patients’ pharmacologic treatment was reviewed and discussed at an interdisciplinary treatment conference led by a clinical pharmacology specialist, or a control group (n = 26) receiving standard care.
- All participants underwent psychometric testing, side effect screening, and clinical interviews and had drug regimens and biochemical test results extracted from electronic health records at baseline and 6 months of follow-up.
- The average follow-up duration of this study was 7 months, and 48 patients completed the trial.
TAKEAWAY:
- The intervention group had a median reduction of one prescription drug compared with a median increase of two prescription drugs in the control group (P < .001); a reduction in the usage of both somatic and antipsychotic drugs was observed in the intervention group.
- Similarly, the number of potentially inappropriate prescriptions decreased by a median of one in the intervention group but increased by a median of two in the control group (P < .001); the main contributing factor was the presence of missing or inappropriate indications.
- No significant changes in the number of potentially significant drug interactions or clinical outcomes were found between the two groups.
IN PRACTICE:
“Rather than conducting medication reviews by solely reviewing drug regimens, interdisciplinary dialogue may address the often complex and conflicting reality clinicians face when treating multimorbid psychiatric patients. Interdisciplinary dialogue may improve the applicability of medication reviews particularly in a psychiatric setting,” the authors wrote.
SOURCE:
This study was led by Johan Frederik Mebus Meyer Christensen, Mental Health Service West, Copenhagen University Hospital ― Psychiatry West Region Zealand, Region Zealand, Denmark, and was published online on April 27, 2025, in the British Journal of Clinical Pharmacology.
LIMITATIONS:
The follow-up time varied between 5 and 11 months as some patients cancelled appointments due to mental deterioration, which may have affected the accuracy of psychometric test scores. Patients who had already received consultations from the clinical pharmacologist were excluded from the study, which may have left out those most likely to benefit from the intervention. Effects of the intervention may have been diminished as clinical staff learned from the conferences and applied insights to all patients.
DISCLOSURES:
This study was supported by a grant from Steno Diabetes Center Zealand and Region Zealand. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
