THE IMPROVEMENT OF MEDICATION ADHERENCE, CLINICAL OUTCOMES, AND QUALITY OF LIFE IN PATIENTS WITH SCHIZOPHRENIA POST IMPLEMENTATION OF PHARMACIST-LED EMESYS MODULE

(STUDY AT MENUR MENTAL HOSPITAL SURABAYA)

Medication non-adherence and metabolic syndrome are the main problems for patients with schizophrenia. The use of second-generation antipsychotics (SGAs) as drugs of choice have been associated with increased weight gain, insulin resistance, and profile lipid abnormalities. The aims of this study are to describe the use of antipsychotics and examine the influence of pharmacist-led Education and Metabolic Syndrome Screening (EMESYS) on medication adherence, metabolic syndrome, risk of cardiovascular disease, and quality of life among patients with schizophrenia at Menur Mental Hospital Surabaya. A series of approaches were used from observational study of antipsychotics used in the hospital between 2019 and 2020 to trial of EMESYS module which involved 46 schizophrenia outpatients.  Medication Adherence Rating Scale (MARS) questionnaire was used to measure medication adherence, Indonesian Modification Subjective Well-being under Neuroleptic (IM-SWN) questionnaire for measuring quality of life, metabolic syndrome was assessed based on National Cholesterol Education Program/Adult treatment Panel III (NCEP/ATP III) parameters for the Asian population and the risk of cardiovascular was measured using the Framingham Risk Score (FRS), respectively. This study showed that risperidon and clozapine were two most commonly used SGAs. EMESYS approach has improved medication adherence improved (p<0.001) and reduced risk of cardiovascular (p=0.038). However, metabolic syndrome and quality of life were not affected (p>0.05). In conclusion, SGAs have been commonly used in the Menur Mental Hospital for treatment of schizophrenia. Pharmacist-led EMESYS module can be implemented particularly in patients using SGAs given the positive results on medication adherence, risk of cardiovascular disease, metabolic syndrome, and quality of life.

Keywords: Schizophrenia, Antipsychotics, Metabolic Syndrome, Adherence