Utilizing clinical pharmacists to improve delivery of evidence-based care for depression and anxiety in primary care

Abstract

Access to mental health providers has become an increasingly common challenge for many patients with depression and anxiety disorders. Primary care providers often manage this gap in care and currently provide solo care without the assistance of other team members. In order to provide quality care that aligns with best practice, we developed a depression and anxiety disorder treatment pathway utilizing a multidisciplinary team based on each members' individual skill set, or skill-task alignment. The main change to treatment implemented by the pathway was the addition of a clinical pharmacist in the management of patient care. This pathway was trialed over five months targeting two adult primary care teams (approximately 34 physicians and Advanced Registered Nurse Practitioners [ARNPs]) while the other five teams continued with current practice standards. Post-implementation metrics indicated that clinical pharmacists successfully contacted 55% (406 of 738) of patients started on medication or who had a medication changed. Of these patients reached, 82 (20%) had an intervention completed. In addition, all physician leaders on the planning team (n=6) stated the new pathway was well received and delivered positive feedback from team members.

Psychiatric Pharmacy: New Role of Pharmacists in Mental Health

“…Clinical pharmacists increased their skillset for treating depression and anxiety and enhanced their ability to make interventions with patients who are referred to them for other chronic disease state management (e.g. hypertension, chronic pain) [44]. Though pharmacists are trained in psychopharmacology, they lack formal MH intervention skills [29].…”

Provider perceptions of pharmacists providing mental health medication support in patient-centered medical homes

“…Additionally, studies have indicated the impact of clinical pharmacists improving medication management of patients with mental health conditions in the primary care setting. [12][13][14][15][16][17] Therefore, it is critical to explore PCP's attitudes toward pharmacist-provided mental health medication support within the PCMH and the needs of PCPs in mental health management in the design of a new pharmacy service. PCMH pharmacy and psychiatry leadership within our academic medical center are exploring ways to help support the management of patients with mental health conditions, primarily around medication management and education.…”

Impact of a specialist mental health pharmacy team on medicines optimisation in primary care for patients on a severe mental illness register: a pilot study

“…This study aimed to explore the gaps in service provision relating to medicines and determine whether a specialist pharmacy team could provide useful input for patients on the SMI register. In primary care, specialist input is uncommon, although some benefit has been demonstrated for depression and dementia10 11; however, involvement of specialist mental health pharmacists for SMI in a GP setting has not been explored.…”