Role of a Psychiatric Pharmacist in a Los Angeles “Skid-Row” safety-net clinic

Wang, Indriani; Dopheide, Julie A.; Gregerson, Paul

doi:10.1007/s11524-011-9573-6

Cited by 21 publications

(19 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A AF nos CAPS demanda adequado planejamento a fim de cumprir com seu objetivo de proporcionar a assistência terapêutica integral, promoção e recuperação da saúde, podendo as farmácias destes centros se tornarem referên-cia na dispensação de medicamentos da saúde mental 14 . Em um modelo de atenção colaborativa a participação do farmacêutico nos CAPS é fundamental, visto que este profissional pode estabelecer o primeiro contato com o usuário ou atuar como um elo com os demais profissionais da equipe de saúde mental, principalmente com o médico, e participar em estratégias de adesão atuando no cuidado à saúde mental 15,16 . A avaliação dos serviços de saúde faz parte do processo de planejamento e gestão, sendo capaz de subsidiar parâmetros importantes no desenvolvimento de novas estratégias e alterações no serviço.…”

Section: Introductionunclassified

Assistência Farmacêutica na Saúde Mental: um diagnóstico dos Centros de Atenção Psicossocial

Silva

Lima

2017

Ciênc. saúde coletiva

View full text Add to dashboard Cite

Resumo O estudo avaliou as condições da Assistência Farmacêutica (AF) nos Centros de Atenção Psicossocial (CAPS) por meio de um estudo transversal em 15 CAPS na região do Médio Paraopeba, Minas Gerais. A coleta de dados foi realizada por meio de observação direta dos CAPS e entrevistas com farmacêuticos e gestores da AF. Os instrumentos foram baseados em indicadores propostos pela OMS, documentos técnicos para organização da AF, na legislação e recomendações que visam as Boas Práticas Farmacêuticas. Foram identificadas 13 unidades de dispensação, sendo nove delas internas aos CAPS. Os serviços apresentaram listas de medicamentos essenciais atualizadas e alta disponibilidade dos principais utilizados nos tratamentos da saúde mental. Todas as cidades participavam de um consórcio intermunicipal para aquisição de medicamentos. A identificação completa dos medicamentos estava presente em apenas sete serviços e todos apresentaram falhas na rastreabilidade dos que foram dispensados. Nos CAPS há apenas um profissional farmacêutico em parte do período de funcionamento e foi identificada apenas uma atividade direcionada aos usuários relacionada ao uso de medicamentos em um dos CAPS. Verificou-se a necessidade de maior participação do farmacêutico no controle e padronização das atividades dos CAPS e principalmente nas atividades assistenciais compondo a equipe de referência em Saúde Mental.

show abstract

Section: Introductionunclassified

Assistência Farmacêutica na Saúde Mental: um diagnóstico dos Centros de Atenção Psicossocial

Silva

Lima

2017

Ciênc. saúde coletiva

View full text Add to dashboard Cite

show abstract

“…Because patients with behavioural health disorders and persons experiencing homelessness are at increased risk of experiencing MRPs, it is important to know how to implement cost‐effective methods for resolving MRPs in this population. Previous studies have demonstrated that pharmacists are successful at identifying and helping resolve MRPs for patients in the safety‐net setting [5,7] . One study has shown that psychiatric pharmacists are particularly effective in helping manage MRPs for homeless and mentally ill patients [5] .…”

Section: Discussionmentioning

confidence: 99%

“…[5,7] One study has shown that psychiatric pharmacists are particularly effective in helping manage MRPs for homeless and mentally ill patients. [5] Pharmacists can be a valuable resource to optimize patient health outcomes, yet it is critical to efficiently allocate pharmacist resources to patients who need care the most. In a safety-net clinic where funding is often a limiting factor, targeting patients who are at higher risk of MRPs for pharmacist services may be an effective strategy.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of chronic behavioural health conditions requires complex therapy, the cornerstone of which is psychiatric medication [1,2] . When used appropriately, psychiatric medications help to relieve disease symptoms, prevent hospitalization and improve quality of life; however, improper use of these medications can result in medication‐related problems (MRPs), such as suboptimal treatment outcomes and an increased cost burden to the healthcare system [1–5] . In fact, several studies have linked psychiatric medication non‐adherence to poor disease management [6] and cyclical relapses, [2,3,6] with an economic burden of over US$800 million in hospital costs annually [6]…”

Section: Introductionmentioning

confidence: 99%

“…[1,2] When used appropriately, psychiatric medications help to relieve disease symptoms, prevent hospitalization and improve quality of life; however, improper use of these medications can result in medication-related problems (MRPs), such as suboptimal treatment outcomes and an increased cost burden to the healthcare system. [1][2][3][4][5] In fact, several studies have linked psychiatric medication nonadherence to poor disease management [6] and cyclical relapses, [2,3,6] with an economic burden of over US$800 million in hospital costs annually. [6] In addition to non-adherence, behavioural health patients may also experience other MRPs, which include adverse events, ineffective drug therapy, need for additional drug therapy, unnecessary drug therapy and drug interactions.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The relationship between medication-related problems and behavioural health condition among patients served by a health care for the homeless centre

Marks¹,

Moczygemba

Gatewood

et al. 2012

Journal of Pharmaceutical Health Services Research

View full text Add to dashboard Cite

Objectives To evaluate the association between behavioural health conditions and the presence of a medication‐related problem (MRP) and the association between the type of MRP and the presence of a dual diagnosis. Methods We used an existing database from a behavioural health clinic for homeless persons. Logistic regression was used to assess the relationship between the type of behavioural health condition and MRP presence, and whether the type of MRP varied with the presence of a dual diagnosis. Key findings A total of 426 patients were eligible. The majority were black (61%) and women (53%). Patients were 44.7 ± 10.2 years old, taking 3.4 ± 2.4 medications and had 2.3 ± 0.9 behavioural health conditions. The majority (53%) had a dual diagnosis, 44% had depression, 30% had a bipolar disorder, 26% had a personality disorder and 12% had an anxiety disorder. Bipolar [odds ratio (OR) 4.0, 95% confidence interval (CI) 1.8–8.9] and anxiety disorders (OR 3.1, CI 1.0–9.2) and a dual diagnosis (OR 2.1, CI 1.2–3.8) were independently associated with the presence of an MRP. Patients with a dual diagnosis were more likely to have ineffective drug therapy (OR 1.7, CI 1.1–2.8) and less likely to have an adverse effect (OR 0.5, CI 0.3–0.9). Conclusions Patients with bipolar or anxiety disorders and/or a dual diagnosis may benefit from a pharmacist intervention to address MRPs. Pharmacists can make recommendations to improve the effectiveness of patients' medication therapy and help to resolve adverse effects.

show abstract

Collaborative practice agreement in solid organ transplantation

et al. 2018

View full text Add to dashboard Cite

Background Given the complexity of solid organ transplant recipients, a multidisciplinary approach is required. To promote medication safety and enable providers to focus on the medical and surgical needs of these patients, our department of pharmacy created a collaborative practice agreement between physicians and pharmacists. Through this agreement, credentialed pharmacists are empowered to provide inpatient services including initiation and adjustment of medications through independent review of laboratory results after multidisciplinary rounds. Objective To evaluate the effect of our collaborative practice agreement on clinical care and institutional finances. Setting An inpatient setting at a large academic medical center. Methods Three transplant pharmacists entered all clinical interventions made on abdominal transplant recipients between September and October 2013 into Quantifi, a software application that categorizes and assigns a cost savings value based on impact and type of intervention. Main outcome measure The main outcome measures in this study were number and categorization of interventions, as well as estimated cost savings to the institution. Results There were 1060 interventions recorded, an average of 20 interventions per pharmacist per day. The most common interventions were pharmacokinetic evaluations (36%) and dose adjustments (19%). Over the time period, these interventions translated into an estimated savings of $107,634.00, or an annual cost savings of $373,131.20 per pharmacist, or a cost-benefit ratio of 2.65 to the institution. Conclusions Based on our study, implementation of a collaborative practice agreement enables credentialed pharmacists to make clinically and financially meaningful interventions in a complex patient population.

show abstract

Role of a Psychiatric Pharmacist in a Los Angeles “Skid-Row” safety-net clinic

Cited by 21 publications

References 12 publications

Assistência Farmacêutica na Saúde Mental: um diagnóstico dos Centros de Atenção Psicossocial

Assistência Farmacêutica na Saúde Mental: um diagnóstico dos Centros de Atenção Psicossocial

The relationship between medication-related problems and behavioural health condition among patients served by a health care for the homeless centre

Collaborative practice agreement in solid organ transplantation

Contact Info

Product

Resources

About