Home medication management problems and associated factors among psychiatric patients under home care pharmacy services at government hospitals in west Malaysia

Background: Proper home medication management plays a role in improving medication adherence, preserving drug efficacy and ensuring safe medication practices, which is crucial to establish positive treatment outcomes. However, no published studies are available on home medication management among psychiatric patients. The study aimed to identify home medication management problems among psychiatric patients in Malaysia and to examine the association between inappropriate medication storage and lack of medication administration schedule with socio-demographic factors, disease insight, number of medication and type of Home Care Pharmacy Services (HCPS). Methods This multicentre cross-sectional study was conducted among psychiatric patients under HCPS in six government hospitals in west Malaysia. Data was extracted from the HCPS form used for each visit as per protocol published by the Pharmaceutical Services Division, Ministry of Health Malaysia. A minimum sample size of 169 was needed. Proportional random sampling was applied. Associations between inappropriate medication storage and lack of medication administration schedule with study parameters were analysed using multiple logistic regressions. Results A total of 205 home visits were conducted with 229 home medication management problems identified; inappropriate medication storage and lack of medication administration schedule topped the list. Inappropriate medication storage was significantly associated with low income [AOR=4.34 (95%CI 1.17:15.98), p=0.027], alcohol consumption [AOR=14.26 (95%CI 1.82:111.38), p=0.011], poor insight [AOR=2.34 (95%CI 1.08:5.06), p=0.030] and part-time HCPS [AOR=2.60 (95%CI 1.20:5.67), p=0.016]. Lack of administration schedule was significantly associated with low income [AOR=6.90 (95%CI 1.46:32.48), p=0.014], smoking [AOR=2.43 (95%CI 1.20:4.92), p=0.013], poor insight [AOR=5.32 (95%CI 2.45:11.56), p<0.05] and part-time HCPS [AOR=2.96 (95%CI 1.42:6.15), p=0.004]. Conclusions Inappropriate medication storage and lack of medication administration schedule is common among psychiatric patients. The study also highlighted the potential of HCPS to improve disease insight and home medication management among psychiatric patients, provided if the service is utilised fully.