Implementing Psychopharmacology Rounds in a Nursing Facility to Improve Antipsychotic Usage

Sasson, Evan; James, Marian; Wubshet, Berhane; Todorov, Darko; Cohen, Henry

doi:10.4140/tcp.n.2017.352

Cited by 4 publications

(9 citation statements)

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“…The majority of studies were located in the United States, UK and Australia with smaller numbers from the Netherlands, Canada and Belgium . Twelve papers reported randomised controlled trials, and five were non‐randomised controlled studies, with the remainder pre‐/post‐uncontrolled interventions conducted as service evaluations. Papers ranged in publication dates from 1978 to 2019, and all services reported positive outcomes with respect to their main aim.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen papers stated that the pharmacist delivering the service was a ‘consultant’, and twelve papers noted that the pharmacist was described as ‘clinical’ . Five papers reported that the pharmacist had completed an accreditation process, one of which described the training as consisting of consultation skills, identification of drug‐related problems, guidelines and how to create pharmaceutical care plans.…”

Section: Resultsmentioning

confidence: 99%

“…Care home culture was cited in one paper as a reason for medicines changes not being implemented . Watching medicines administration and providing feedback on errors as well at routine attendance at ward rounds to discuss antipsychotic medication use were seen as effective at changing cultures.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review and narrative synthesis of pharmacist provided medicines optimisation services in care homes for older people to inform the development of a generic training or accreditation process

Wright

Maskrey

Blyth

et al. 2019

International Journal of Pharmacy Practice

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Objectives To develop a training programme to enable pharmacists with prescribing rights to assume responsibility for the provision of pharmaceutical care within care homes, a systematic review and narrative synthesis was undertaken to identify reported approaches to training pharmacists and use this literature to identify potential knowledge requirements. Methods A PROSPERO-registered systematic review was performed using key search terms for care homes, pharmacist, education, training and pharmaceutical care. Papers reporting primary research focussed on care of the older person within the care home setting were included. No restrictions were placed on methodology. Two researchers independently reviewed titles, abstracts and papers. Agreement on inclusion was reached through consensus. Data on titles, training and activities undertaken were extracted and knowledge requirements identified. Findings were synthesised and reported narratively. Key findings Fifty-nine papers were included, most of which were uncontrolled service evaluations. Four papers reported an accreditation process for the pharmacist. Thirteen papers reported providing tools or specific training on a single topic to pharmacists. The main clinical and therapeutic areas of activity (requiring codified knowledge) were dementia, pain, antipsychotic and cardiovascular medication. Provision of pharmaceutical care, effective multidisciplinary working and care home staff training represented the main areas of practical knowledge. Conclusions Information regarding training and accreditation processes for care home pharmacists is limited. This study provides insight into potential codified and practical knowledge requirements for pharmacists assuming responsibility for the provision of pharmaceutical care within care homes. Further work involving stakeholders is required to identify the cultural knowledge requirements and to develop a training and accreditation process.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review and narrative synthesis of pharmacist provided medicines optimisation services in care homes for older people to inform the development of a generic training or accreditation process

Wright

Maskrey

Blyth

et al. 2019

International Journal of Pharmacy Practice

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“…Additional members of interdisciplinary teams, often tailored to the specific needs of facilities and populations, include nursing, 56 social workers and administration. 54 Since nursing assistants provide most of the direct resident care in nursing homes and are often with specific residents over extended time periods, 62 , 63 selectively including them when major plans of care and/or medications are proposed may be beneficial.…”

Section: Discussionmentioning

confidence: 99%

A nurse practitioner led protocol to address polypharmacy in long-term care

Bergman-Evans

2020

Geriatric Nursing

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Highlights Polypharmacy is common in long term care facilities and frequently associated with poor outcomes. A focus on decreasing polypharmacy as part of 60-day periodic review process in long term care facilities has the potential to improve resident outcomes and assist health care providers in improved medication management. To achieve success in decreasing polypharmacy, an interdisciplinary team with shared goals and communication is needed.

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“…One study was based in early intervention/psychosis services [86] and one based in other (mix of urban, non-urban and metropolitan centres) [71,72]. Pharmacists were involved to some extent in delivering the interventions across all studies, and those involved were mostly commonly specialist mental health/psychiatric pharmacists (n = 9) [73,79,83,[85][86][87][88][89][90] or clinical pharmacists (n = 9) [76,78,81,82,[91][92][93][94][95] (Table 4). Differences in terminology across studies due to differences in country of origin did not allow us to differentiate grades or qualification of pharmacists.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review

et al. 2021

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Background Individuals with severe mental illness, e.g. schizophrenia have up to a 20% shortened life expectancy compared to the general population. Cardiovascular disease, due to cardiometabolic risk and metabolic syndrome, accounts for most of this excess mortality. A scoping search revealed that there has not been a review of published studies on the role of pharmacy in relation to cardiometabolic risk, metabolic syndrome and related diseases (e.g. type 2 diabetes) in individuals with severe mental illness. Methods A mixed-methods systematic review was performed. Eleven databases were searched using a comprehensive search strategy to identify English-language studies where pharmacy was involved in an intervention for cardiometabolic risk, metabolic syndrome or related diseases in severe mental illness in any study setting from any country of origin. First, a mapping review was conducted. Then, implementation strategies used to implement the study intervention were classified using the Cochrane Effective Practice and Organisation of Care Taxonomy. Impact of the study intervention on the process (e.g. rate of diagnosis of metabolic syndrome) and clinical (e.g. diabetic control) outcomes were analysed where possible (statistical tests of significance obtained for quantitative outcome parameters reported). Quality assessment was undertaken using a modified Mixed Methods Appraisal Tool. Results A total of 33 studies were identified. Studies were heterogeneous for all characteristics. A total of 20 studies reported quantitative outcome data that allowed for detailed analysis of the impact of the study intervention. The relationship between the total number of implementation strategies used and impact on outcomes measured is unclear. Inclusion of face-to-face interaction in implementation of interventions appears to be important in having a statistically significantly positive impact on measured outcomes even when used on its own. Few studies included pharmacy staff in community or general practitioner practices (n = 2), clinical outcomes, follow up of individuals after implementation of interventions (n = 3). No studies included synthesis of qualitative data. Conclusions Our findings indicate that implementation strategies involving face-to-face interaction of pharmacists with other members of the multidisciplinary team can improve process outcomes when used as the sole strategy. Further work is needed on clinical outcomes (e.g. cardiovascular risk reduction), role of community pharmacy and qualitative studies. Systematic review registration PROSPERO CRD42018086411

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Implementing Psychopharmacology Rounds in a Nursing Facility to Improve Antipsychotic Usage

Abstract: Implementing interdisciplinary psycho-pharmacology rounds in a nursing facility resulted in a reduction of inappropriate antipsychotic use and improved monitoring and documentation.

Cited by 4 publications

References 0 publications

Systematic review and narrative synthesis of pharmacist provided medicines optimisation services in care homes for older people to inform the development of a generic training or accreditation process

Systematic review and narrative synthesis of pharmacist provided medicines optimisation services in care homes for older people to inform the development of a generic training or accreditation process

A nurse practitioner led protocol to address polypharmacy in long-term care

The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review

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