Cynthia Cheng1, Fatima Mithoowani2, Thomas Ungar3, Monica Lee4. 1. , BScPhm, PharmD, BCPS, RPh, is with North York General Hospital and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario. 2. , BScPhm, RPh, is with North York General Hospital, Toronto, Ontario. 3. , MD, MEd, CCFP, FCFP, FRCPC, DABPN, is with the Faculty of Medicine, University of Toronto, and St Michael's Hospital, Toronto, Ontario. 4. , BScPhm, MSc, PharmD, RPh, is with North York General Hospital and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.
Abstract
BACKGROUND: Interaction between alcohol and certain medications can lead to adverse consequences. Individuals with mental health disorders are particularly vulnerable because of their psychotropic medications, which are typically taken over extended periods and which are known to have pharmacokinetic and pharmacodynamic interactions with alcohol. It is unknown what education these patients receive from their health care providers and how such interactions are managed. OBJECTIVES: To determine whether individuals with mental health disorders are aware of alcohol-drug interactions and if so, how they use such information. METHODS: A questionnaire was developed to explore the perceptions of mental health patients concerning alcohol-drug interactions. The questionnaire included questions in 3 domains: knowledge of potential alcohol-drug interactions, consumption of alcohol while taking psychotropic medications, and source of advice regarding the interactions. Attendees of an adult mental health day hospital program were invited to participate. RESULTS: A total of 131 participants answered the questionnaire between July 2014 and February 2015; 31 of the questionnaires were incomplete and were excluded from analysis. Of the 100 participants included in the analyses, 75 reported having received counselling from a health care provider about alcohol-drug interactions, and 49 of these reported following the advice provided. The most common advice reported by participants was to avoid alcohol consumption while taking medications. Serious adverse effects, such as worsening of a psychiatric condition, admission to hospital, and increased drowsiness, were reported by 23 participants. Sixty-nine participants considered physicians to be the best source of information about these interactions. CONCLUSIONS: Most participants reported that they had received information about strategies to avoid negative consequences from alcohol-drug interactions. Nevertheless, consumption of alcohol occurred, and almost one-quarter of participants reported a serious adverse effect related to consuming alcohol. These self-reported data indicate that patients do not necessarily follow the advice of their health care providers. Future studies should explore reasons for the gap between advice and action and how to minimize it.
BACKGROUND: Interaction between alcohol and certain medications can lead to adverse consequences. Individuals with mental health disorders are particularly vulnerable because of their psychotropic medications, which are typically taken over extended periods and which are known to have pharmacokinetic and pharmacodynamic interactions with alcohol. It is unknown what education these patients receive from their health care providers and how such interactions are managed. OBJECTIVES: To determine whether individuals with mental health disorders are aware of alcohol-drug interactions and if so, how they use such information. METHODS: A questionnaire was developed to explore the perceptions of mental health patients concerning alcohol-drug interactions. The questionnaire included questions in 3 domains: knowledge of potential alcohol-drug interactions, consumption of alcohol while taking psychotropic medications, and source of advice regarding the interactions. Attendees of an adult mental health day hospital program were invited to participate. RESULTS: A total of 131 participants answered the questionnaire between July 2014 and February 2015; 31 of the questionnaires were incomplete and were excluded from analysis. Of the 100 participants included in the analyses, 75 reported having received counselling from a health care provider about alcohol-drug interactions, and 49 of these reported following the advice provided. The most common advice reported by participants was to avoid alcohol consumption while taking medications. Serious adverse effects, such as worsening of a psychiatric condition, admission to hospital, and increased drowsiness, were reported by 23 participants. Sixty-nine participants considered physicians to be the best source of information about these interactions. CONCLUSIONS: Most participants reported that they had received information about strategies to avoid negative consequences from alcohol-drug interactions. Nevertheless, consumption of alcohol occurred, and almost one-quarter of participants reported a serious adverse effect related to consuming alcohol. These self-reported data indicate that patients do not necessarily follow the advice of their health care providers. Future studies should explore reasons for the gap between advice and action and how to minimize it.