Objective. To analyze the cost avoidance resulting from clinical interventions made by pharmacy students completing an advanced pharmacy practice experience (APPE) at a psychiatric hospital. Methods. A retrospective database review of documented clinical interventions by pharmacy students was conducted to classify interventions by type and significance. Interventions were assigned a cost avoidance value determined by an evaluation of the literature. Results. Three hundred-twenty interventions were documented by 15 pharmacy students during the 1-year study period. The majority of interventions were related to psychiatric medication classes and most (n 5 197; 61.6%) were classified as being of moderate significance. The most common interventions included patient education (13.1%), order clarification (11.6%), therapeutic dosing adjustments (10.9%), and laboratory order monitoring (8.8%). The estimated cost avoidance from all interventions made by pharmacy students was approximately $23,000. Conclusions. Pharmacy students completing APPEs at a psychiatric hospital contributed to a variety of significant clinical interventions and provided considerable cost avoidance value to the institution.
There is limited literature addressing the safety of administering electroconvulsive therapy (ECT) to patients concomitantly receiving bupropion monotherapy or in combination with other drugs that may alter the seizure threshold. We describe a prolonged seizure occurring during the first treatment of a course of ECT in an adult patient receiving long-term bupropion therapy, lithium, and venlafaxine.
Objective:
The emphasis on reducing the duration of untreated psychosis (DUP) has highlighted complex barriers to accessing appropriate services. Internet and social media use by individuals with first-episode psychosis (FEP) was examined to explore how these platforms might be used to facilitate treatment initiation.
Methods:
Participants ages 15–35 were interviewed with the Pathways to Care for Psychosis Questionnaire, an 81-item instrument designed to explore online activity during symptom emergence.
Results:
Of 112 participants, 90% used the Internet and social media daily. The Internet was listed as the most used resource (62%) for information while symptoms were emerging. A minority (19%) shared concerns via social media, and 76% responded favorably to the possibility of receiving online mental health support.
Conclusions:
The Internet and social media were part of daily life for participants with FEP. Activity continued throughout the DUP, offering the prospect of earlier intervention. Participants expressed positive attitudes toward Internet-based outreach and engagement efforts.
A detailed qualitative analysis revealed that PGY2 psychiatric pharmacy residents' interventions were largely accepted, focused on medication adjustments for psychiatric conditions, and were of moderate significance at two state psychiatric facilities. Antipsychotics were associated with the greatest cost avoidance and total number of interventions.
ADRs were most commonly associated with mood stabilizers and antipsychotics, and pADRs were common. There is an opportunity to provide education to medical staff on therapeutic drug monitoring and drug-drug interactions for these classes, particularly lithium.
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