5 research outputs found
Medication Exposure in Highly Adherent Psychiatry Patients
Medication exposure
is dependent upon many factors, the single
most important being if the patient took the prescribed medication
as indicated. To assess medication exposure for psychotropic and other
medication classes, we enrolled 115 highly adherent psychiatry patients
prescribed five or more medications. In these patients, we measured
21 psychotropic and 38 nonpsychotropic medications comprising a 59
medication multiplex assay panel. Strict enrollment criteria and reconciliation
of the electronic health record medication list prior to study initiation
produced a patient cohort that was adherent with 91% of their prescribed
medications as determined by comparing medications detected empirically
in blood to the electronic health record medication list. In addition,
13% of detected medications were not in the electronic health record
medication list. We found that only 53% of detected medications were
within the literature-derived reference range with 41% below and 6%
above the reference range specific to each medication. When psychotropic
medications were analyzed near trough-level, only sertraline was found
to be within the literature-derived reference range for all patients
tested. Concentrations of the remaining medications indicated extensive
exposure below the reference range. This is the first study to empirically
and comprehensively assess medication exposure obtained in comorbid
polypharmacy patients, minimizing the important behavioral factor
of adherence in the study of medication exposure. These data indicate
that low medication exposure is extensive and must be considered when
therapeutic issues arise, including the lack of response to medication
therapy