Impact of a clinical pharmacist on medication safety in mental health Hospital-in-the-Home: a retrospective analysis

Abstract

Background Integration of clinical pharmacists into multidisciplinary Mental Health Hospital-in-the-Home teams is increasing but little is known about the medication safety contribution these pharmacists make. Aim To evaluate whether clinical pharmacist involvement in a Mental Health Hospital-in-the-Home service improved medication safety key performance indicators. Method Medical records were retrospectively reviewed of all patients admitted to 2 Western Australian Mental Health Hospital-in-the-Home services from September to November 2015. Site 1 was a 16-bed service incorporating a clinical pharmacist as part of its multidisciplinary team. Site 2 was a similarly structured 18-bed service but without clinical pharmacist involvement. The primary outcome measure was completion of medication safety key performance indicators obtained from the Western Australian Government Pharmaceutical Review Policy and mental health-specific best practice guidelines. Results Key performance indicators from Site 1 (n = 75 records), which incorporated a clinical pharmacist, demonstrated significantly (p < 0.001) higher rates of completion of medication reconciliation [65 (87%) versus 17 (29%)], accurate adverse drug reaction list [73 (97%) versus 34 (58%)], accurate discharge medication list [51 (74%) versus 18 (45%)], accurate medication profile [74 (99%) versus 40 (68%)] and medication chart review [74 (99%) versus 0 (0%)] than Site 2 (n = 59). Conclusion Integrating a clinical pharmacist into a Mental Health Hospital-in-the-Home program significantly improved achievement of medication safety key performance indicators.

A bibliometric analysis of global trends in the research field of pharmaceutical care over the past 20 years

“…Furthermore, based on the spontaneous reporting and active surveillance systems ( 47 ), the pharmacovigilance and drug and therapeutics committee could assist in monitoring the quality and safe use of medicines to improve medication safety ( 48 ). Another important part of the clinical pharmacist's role is medication reconciliation and supporting patient adherence ( 49 ), especially in geriatrics. Medication reconciliation at admission to the hospital reduces the prevalence of medication errors.…”

The impact of pharmacists on medication safety in mental health: A narrative review

“…Another study by Farag and colleagues in 2015 was based on a retrospective analysis that involved reviewing 135 patient case notes from two separate sites in a Mental Health Hospital-in-the-Home program which incorporated a clinical pharmacist only at Site 1. 25 The clinical pharmacists at Site 1 demonstrated significantly higher key performance indicators (KPIs). The KPIs, including medication safety and clinical outcomes from Site 1 (n = 75 records), were significantly higher compared to Site 2 ( p < 0.001).…”

“…Six studies included in the review aimed to analyze pharmacist-led support programs related to reducing general DRPs. [22][23][24][25][26]34 The studies highlighted the high incidence of DRPs in patients with mental health illnesses, averaging two DRPs per pharmacist encounter. Pharmacists identified and reduced DRPs through medication reconciliation, chart review, MTM, and CMM.…”

“…19 Although their roles are like those in the United States, they generally have more autonomy as compared to pharmacists in the United States. 25 Therefore, pharmacists in the United States for the most part have limited independent authority to do interventions and prevent medication errors if the prescriber does not concur. 37 In addition to scope of practice, the perception and trust of prescribers on pharmacists, play a big role in accepting recommendations from pharmacists in settings where pharmacists cannot independently make interventions.…”

Mental health symptoms and their associated factors among pharmacists in psychiatric hospitals during the early stage of the COVID-19 pandemic

“…The misunderstanding of psychiatric care and the stigma of the illness may make psychiatric patients more reluctant to seek psychiatric care (Lahariya et al, 2010), and this may affect the morale and attitude of pharmacists working in psychiatric hospitals. A recent study highlighted the importance of including pharmacists in the home care plans of patients with mental disorders, thereby improving medication safety (Farag et al, 2022). Therefore, supporting the mental health and well-being of pharmacists in psychiatric hospitals is of great importance for the well-being of patients.…”