IMPACT OF PATIENT COUNSELLING AND PATIENT EDUCATION BY THE CLINICAL PHARMACISTS IN THE MANAGEMENT OF DELUSIONAL DISORDER,ANXIETY,MANIAC PATIENTS WITH PSYCHOSIS BY ADMINISTERING PLACEBO IN REPLACEMENT OF OLANZAPINE: A RANDOMIZED SINGLE BLIND CONTROLLED STUDY.

Mounika Pamukuntla, Deepika Bojja, Mounika Burgupally, Mekala Anusha, Nikhil Chinka

Abstract


Title

 “Impact of patient counselling and patient education by the clinical pharmacist in the management of delusional disorder ,anxiety, maniac patients with psychosis by administering placebo in replacement of olanzapine: A Randomized single blind controlled study”.

Back ground of the study

Psychosis, anxiety, maniac,delusional disorders are the major central nervous system disorders which are causing major change to the patients of all the ages.

Objectives

The objective of this study is to evaluate the role  of clinical pharmacist in providing affective patient counselling by replacing olanzapine with placebo in psychosis patients

Study design, Study duration

A Prospective, Single blind , Randomized controlled trial was conducted from Dec 2017-May 2018 at a 350-beded Tertiary care teaching hospital in Sangareddy, Telangana.

Methodology

200 patients were enrolled in this study and divided into two Groups .To Group A (Control group) patients were given with conventional antipsychotics therapy and to group B patients (Case group) where Olanzapine was replaced with placebo. Successive patient counselling sessions were performed for case group by clinical pharmacist while leaving the control group for conventional therapy and not performed any patient counselling. Patient response was analyzed.

 

Results

Males(59%) were more prone to psychosis when compared with female(41%).More side effects were  experienced by Group A patients when compared to Group B .T-test have been performed where P- value is 0.0128, P < 0.05 so there is statistically significant difference between two groups .Group B (20%) patients gained less weight when compared with Group A(40%). So Group B is more beneficial than Group A. Mean change in scores from baseline to endpoint in beck anxiety scale, young mania rating scale, and positive and negative syndrome scale. Where P-Value is 0.675, P > 0.05. More symptomatic improvement was shown by control group compared to case group. Control group patients spent more money (Rs.2, 564) for treatment when compared to case Group (Rs.726) during study period.

Conclusion

            Our study concludes that replacement of antipsychotic drug (Olanzapine) with placebo from the conventional antipsychotic significant therapy with combined anxiolytics by providing continuous patient counselling and continuous patient monitoring has shown significant reduction of side effects and improved sleeping pattern among the patients who were given with placebo were observed, Although the conventional antipsychotic therapy has shown more significant improvement in relieving the symptoms of psychosis than placebo group. Clinical pharmacist could play an important role in improving the quality of life of psychotic patients 


Keywords


Olanzapine, Placebo, Anxiety, Mania, Delusional disorder.

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