Assessment of the current practice of psychiatric pharmacists in the United States

Abstract

Introduction A comprehensive review of psychiatric pharmacy practice has never been performed in the United States. As psychiatric pharmacists become more involved in mental illness treatment, determining the current state of practice is important to help advance the specialty. The Professional Affairs Committee of the College of Psychiatric and Neurologic Pharmacists (CPNP) was charged with performing this review to define current psychiatric pharmacy practice. Methods An electronic survey was sent to all pharmacist members of CPNP and all nonmember Board Certified Psychiatric Pharmacists (BCPPs) in the United States in late summer 2019. The survey consisted of 36 questions across multiple domains to obtain information about respondents' education and training background, practice setting and type, and information about prescriptive authority and other areas. An initial e-mail invitation was sent along with 2 reminder e-mails over the subsequent 2 weeks. Results A total of 334 of 1015 pharmacists completed the survey (32.9%). Responders completed a postgraduate residency 77.8% of the time, and 88.3% were BCPP. Practice settings were split evenly between inpatient and outpatient practices or a combination of the 2. Among respondents, 46.5% reported having prescriptive authority as part of their practice, and 41.3% reported treating nonpsychiatric as well as psychiatric illnesses. Prescriptive authority was more likely in outpatient practices and in those treating nonpsychiatric illnesses. Discussion The current practice of psychiatric pharmacy is incredibly varied in terms of practice setting, activities performed, and services provided. Further exploration is needed to help determine the optimal role of psychiatric pharmacists.

Survey of prescriptive authority among psychiatric pharmacists in the United States

“…Characteristics of the survey respondents have been described in detail previously. 4 Of the 334 survey respondents, 155 (46.4%) reported having a collaborative practice agreement, VA scope of practice, or alternative PA ( Table 1 ). There is a statistically significant difference in the percentages of respondents practicing with PA in the Northeast versus the West (13.9% vs 34.4%, respectively, P < .05; Figure 1 ).…”

“…Detailed methods for this survey study have been previously described. 4 A database obtained from CPNP was used to identify study participants, which included BCPP and non-BCPP members of CPNP and BCPP non-members of CPNP as of August 30, 2019. The survey contained 36 questions across 5 domains: clinician details/demographics, primary clinical practice facility information, primary clinical practice demographics, prescriptive authority, and professional activities.…”

“…This includes expertise in addressing medication-related problems, such as inadequately treated conditions, drug interactions, adverse effects, and nonadherence. In a recent College of Psychiatric and Neurologic Pharmacists (CPNP) survey, 4 the majority of psychiatric pharmacists reported completing residency training and being Board Certified Psychiatric Pharmacists (BCPPs). They reported managing drug therapy for persons with mental illnesses in inpatient and outpatient settings, in behavioral health and primary care settings, and for those with a variety of psychiatric and common medical diagnoses.…”

Certificates and certification programmes for clinical excellence: A guide to international pharmacists

“…The preference of young generations to take up residency programmes and further to appear for certification programmes has been noticed nowadays. This is a positive sign for clinical pharmacy precipitated by the change in pre-requisite criteria for the official examinations (Silvia et al, 2020). Pharmacists can significantly contribute to long-standing disease conditions.…”

Best practice model for outpatient psychiatric pharmacy practice, part 1: Development of initial attribute statements

“…Of those respondents practicing in the outpatient setting, there was significant variability in the practice type, disease states managed, prescriptive authority authorized, and other clinical activities. 3 Werremeyer and colleagues 4 also found a diverse array of outpatient psychiatric pharmacy practices reported in the literature. Clinical roles ranged from patient education for improving medication adherence, to comprehensive medication review, to medication therapy management.…”