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

Abstract

Introduction A 2019 survey identified significant variability of practice characteristics among outpatient psychiatric pharmacists (OPPs). No published model establishes which attributes constitute best practice for OPPs. By developing a consensus for best practice model attributes, OPPs can work toward consistent, effective patient care. This project aimed to develop attribute statements for a best practice model for OPPs providing direct patient care. Methods Board Certified Psychiatric Pharmacists and American Association of Psychiatric Pharmacists (AAPP) members were questioned using a 5-phase (P1-P5) survey and summit approach. The phases were: P1, broad ideation survey; P2, 10-person summit to develop draft statements; P3, survey of the draft statements for acceptance; P4, summit to resolve review feedback; and P5, survey of AAPP membership to confirm the finalized statements. Results P1 survey results generated a list of 143 possible attributes that informed the P2 summit, which were refined to 28 statements. P3 survey results confirmed at least 70% agreement with each statement. The P4 summit evaluated all P3 survey results and made significant modifications to 4 statements. Informal feedback was sought with other stakeholders, and supporting narratives and references were developed to provide clarity regarding the intent of each statement. Finalized statements and supporting narratives were confirmed in the P5 survey. Discussion The 28 attribute statements were developed over 18 months by gathering input and consensus through multiple modalities, including 3 surveys, 2 summit meetings, and numerous informal feedback requests. The agreement on the attribute statements was consistently high across all phases. The final attribute statements are presented elsewhere in this issue.

Evaluation of a psychiatric pharmacist consultation service in a multispecialty outpatient clinic

“…However, based on identified barriers and limitations, there are key attribute statements that represent growth for psychiatric pharmacy services. These statements include having prescriptive authority or a collaborative practice agreement, receiving reimbursement for clinical services, and having the ability to refer patients to another psychiatric provider for diagnostic clarification 21,22 . Development of a formal consult psychiatry team as well as opportunities for billing of pharmacy services are being explored and may allow for further expansion of psychiatric pharmacy services and improved coordination of psychiatric care in this setting.…”

Best practice model for outpatient psychiatric pharmacy practice, part 2: Confirmation of the attribute statements

“…One limitation of the survey was the low response rate, but current findings aligned with results of previous phases of this project. 2 Throughout phases 1 through 5, there was a wide representation of AAPP members who contributed to the development and confirmation of the statements. Although earlier project phases allowed participants to suggest additional attributes, the design of this survey did not validate whether the attributes represented a complete description of the ideal model.…”

“…The methods and results of the first 4 phases (initial membership survey, summit meetings, follow-up membership survey, and summit review meeting) and other project activities have been described and published elsewhere. 2 In the fifth and final phase, the goal was to measure overall agreement and obtain consensus on what core attributes and qualities should be incorporated within the best practice model among AAPP members.…”