Review clinic for people receiving antidepressants

Association of Focused Medication Review With Optimization of Psychotropic Drug Prescribing

“… 23 , 24 Four studies were cluster RCTs (n = 712 participants) 23 , 24 , 25 , 26 , 27 and the remaining 22 were before-after study designs (n = 7844 participants). 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 Studies were conducted in North America (15 studies), 28 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 39 , 42 , 43 , 46 , 47 , 48 , 49 Europe (10 studies) 23 , 25 , 26 , 27 , 29 , 38 , 40 , 41 , 44 , 45 and Australasia (1 study). 34 A total of 19 studies 23 , 26 , 27 , 28 ,…”

“…The first was one-off medication review, usually undertaken by a single professional and including a single class of psychotropic drug. 23 , 25 , 38 , 40 , 41 , 42 , 43 , 44 , 45 The second model was a longitudinal program of regular medication review, often by a multidisciplinary team who reviewed the participant’s psychotropic drug regimen in a series of meetings. 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 39 The third type of focused psychotropic medication review was 2-stage, in which those at high risk of suboptimal drug therapy were identified using a rule applied to the electronic patient record and then directed to clinician medication review.…”

“… 46 , 47 , 48 , 49 Within this categorization, the configuration of focused psychotropic medication review varied considerably from remote review by a third party to detailed medication review with access to the patient’s full clinical notes and the patient’s direct input to the process ( Table 1 ). 18 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 Medication reviews were most often organized according to local protocols, but specific conduct of the medication review was commonly not reported.…”

“…Studies reported review of antipsychotic drugs (9 studies), 23 , 25 , 29 , 31 , 32 , 37 , 38 , 40 , 41 sedatives and hypnotics (2 studies), 43 , 49 antidepressants (2 studies), 44 , 45 or several psychotropic drug classes concomitantly (13 studies). 26 , 27 , 28 , 30 , 33 , 34 , 35 , 36 , 39 , 42 , 46 , 47 , 48 A range of medical and other health professionals were involved in medication reviews, with the most consistent representation being by clinical pharmacists.…”

“… 44 A similar study, conducted on a much smaller scale (N = 32), reported that medication change followed just above half of the medication reviews conducted by a specialist nurse prescriber. 45 …”