Competent Psychopharmacology

Abstract

There is little doubt that undergraduate and post-graduate training of physicians, pharmacists, and nurses is insufficient to prepare them to use psychotropics safely and effectively, especially in the context of their expanded off-label uses. Therefore, the development of competencies in psychotropic prescribing needs to be approached as a long-term, practice-based learning commitment. Proposed are the abilities and knowledge components necessary for safe and effective use of psychotropics. Typical challenges in prescribing for chronic and recurrent illnesses include highly variable responses and tolerability, drug interactions, and adverse effects that can be serious, irreversible, and even fatal. Prescribing psychotropics is further complicated by negative public and professional reports and growing patient concerns about the quality of care, and questions about the efficacy, safety, and addictive risks of psychotropics. Increased efforts are needed to enhance clinical training and knowledge in psychopharmacology among trainees and practising clinicians, with more comprehensive and sustained attention to the assessment of individual patients, and greater reliance on patient education and collaboration. Improved competence in psychotropic prescribing should lead to more informed, thoughtful, and better-targeted applications as one component of more comprehensive clinical care.

Antipsychotic medication side effects knowledge amongst registered mental health nurses in England: A national survey

“…In addition to quality and safety, medication errors can have economic implications for the healthcare system. In the United Kingdom (UK), the Department of Health report states that preventable medication errors cost the NHS by as much as £2.5bn a year (Torjesen, 2014 (Gardner, 2014). Moreover, the explosion in neuro-scientific and psychological understanding of mental disorders have compounded the problem (Glick & Rush, 2016).…”

“…In support of this view, the results from our regression analysis showed that knowledge gained through experience accounted for only 4% of the variance, suggesting that 96% of the learning was through other means. Because of these limitations, proposals for improving the teaching of psychopharmacology have been discussed (Gardner, 2014;Jones et al, 2010;Skingsley et al, 2006) but the implementation of these strategies remains a significant challenge.…”

“…From a mental health perspective, this raises important questions as 92% of mental health service users in the UK are prescribed psychotropic medicines and nurses play a key role in the management of these medicines (Healthcare Commission, 2007). Further, this stance goes against recommendations from the Royal College of Psychiatrists and the Royal College of Nursing who recommend a greater focus on teaching psychopharmacology and physical health to mental health nurses at both pre-and post-registration level (Gardner, 2014).…”

Innovative methods in teaching psychiatry to medical students

“…Few other subjects may be addressed, looking at the future. The teaching of specific areas of psychiatry, such as child and adolescent psychiatry 25 , competent psychopharmacology 26 , community psychiatry 27 or substance abuse 8 may need a more detailed analysis. We are particularly interested in the potential role of trainees as clinical teachers of medical students in psychiatry 28 ; and are also supportive of the need to try to homogenize the core curricula across medical schools 23 .…”

Patient care activities by community pharmacists in a capitation funding model mental health and addictions program

“…These roles are possible and supported by a trusting public who frequently access pharmacists’ services [ 9 – 11 ]. However, impediments have been described that serve to undermine the potential value of community pharmacists in building on their contributions to mental health and addictions care in their communities [ 12 – 19 ].…”