Pharmaceutical care for obese schizophrenic patitnes at Somdet Chaopraya Institute of Psychiatry

Abstract

The objective of this study was to assess the effects of pharmaceutical care process provided to obese schizophrenic patients. Parameters used to evaluate the effectiveness of this process were body weight, body mass index (BMI), waist circumference and laboratory tests. This study was designed as a before-after experiment with no control group. The study was conducted in 58 obese (BMI [is more than or equal to] 25 kg/m[square]) schizophrenic patients at Somdet Chaopraya Institute of Psychiatry and were followed up for 5 visits with a one-month interval. The patients were provided with pharmaceutical care via the pharmacist activities including 1) identifying excess weight problems and metabolic problems by monitoring of weight, height, BMI, waist circumference and laboratory tests, which included FPG, HbA[subscript 1c] and lipid profile (cholesterol, triglyceride, HDL-C and LDL-C), interviewing the patients and their relatives about the patients eating pattern and physical activity 2) resolving and preventing excess weight problems and metabolic problems by advising patients and their relatives to control diet and exercise, discussing with dietitian to adjust caloric intake to 1,800 kcal per day, asking nurses to take care of patients diet and intervention the metabolic problems to the psychiatrists. The results of this study showed that 62.1% (36 of 58) of the patients could lose their weight at the end of the 4-month study. Furthermore, 29.3% (17 of 58) of the patients could lose their weight more than or equal to 5% of the baseline body weight. Inpatients could achieve their weight reduction for 14 of 18 (77.8%), whereas outpatients could achieve their weight reduction for only 22 of 40 (55%). Thirteen patients were diagnosed as having metabolic syndrome (defined by ATP III) at baseline evaluation. At the end of the study, 9 of 13 were without metabolic syndrome. In conclusion, the pharmaceutical care for obese schizophrenic patients could reduce body weight, BMI and the risk of metabolic complications.