ABSTRACT
OBJECTIVE: Antipsychotics are the standard treatment for psychosis. However, when combined with other lifestyle factors they are partially responsible for an excessive mortality rate. A clinical and paraclinical monitoring of patients is therefore necessary. In 2011, this element led doctors and pharmacists to improve monitoring and formalize a follow-up adapted to inmate patients. The aim of this study was to assess the impact of medical-pharmaceutical collaboration on monitoring quality of patients treated by antipsychotics. METHODS: This is a retrospective study including all patients treated by antipsychotics for at least 6 months in 2011 and again in 2015. Data were collected from medical files. The indicator assessing the monitoring quality was the compliance percentage, of registred parameters for each patient on the basis of specific guidelines. RESULTS: In 2015 compared to 2011, the monitoring quality increased for 9 out of 10 parameters. This improvement was statisticaly significant for 7 of them : Body Mass Index, lipid test, complete blood count, transaminase, ionogram, glycemia, glomerular filtration rate. CONCLUSION: The actions of improvement collectivelly implemented in 2011 had a concrete impact on patients in the follow-up in 2015.
Subject(s)
Antipsychotic Agents/therapeutic use , Monitoring, Physiologic/standards , Patient Safety/standards , Prisons/statistics & numerical data , Psychotic Disorders/drug therapy , Quality of Health Care , Adult , Antipsychotic Agents/adverse effects , Cohort Studies , Delirium/drug therapy , Delirium/epidemiology , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/prevention & control , Female , Guideline Adherence/statistics & numerical data , Humans , Male , Medical Records/standards , Monitoring, Physiologic/methods , Pharmacists/organization & administration , Pharmacists/standards , Prisons/organization & administration , Prisons/standards , Psychotic Disorders/epidemiology , Quality Indicators, Health Care , Quality of Health Care/standards , Retrospective Studies , Schizophrenia/drug therapy , Schizophrenia/epidemiologyABSTRACT
Awaking properties of modafinil are well known at this time, but its action mode is still hypothetic. Our contribution is limited to the study of the membrane structural modifications carried by this drug and two metabolites. By EPR spectroscopy, we have studied the two metabolites which are distinguished by acid function for the first one and sulfone function for the second one. These two metabolites have no waking properties when they are administrated to animals but one of these two metabolites has the same behaviour than modafinil on membrane action.
