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Liu Z, Xue J, Deng Q, Wang Y, Zhang L, Liu L, Xiao N, Chang T, Cui Y, Cheng Y, Liu G, Wang W, Zhou Y, Yang W, Qu X, Chen J, Zhao Y, Wang Z, Yang H. Pharmacokinetics and safety of a new generic lurasidone: a phase I bioequivalence study in healthy Chinese subjects. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:7051-7060. [PMID: 38643450 DOI: 10.1007/s00210-024-03055-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/18/2024] [Indexed: 04/22/2024]
Abstract
Latuda® is a novel antipsychotic drug for schizophrenia and bipolar depression. A bioequivalence trial was performed to investigate the bioequivalence of Latuda® and its generic drug lurasidone. Two independent trials were carried out, each involving 28 subjects. In the fasting trial, subjects were randomly assigned to two groups (1:1 ratio), receiving either 40 mg of generic lurasidone or Latuda®. After a 7-day washout period, subjects entered the second period with a crossover administration of 40 mg of generic lurasidone or Latuda®. The postprandial study design was similar to that of the fasting study. In the fasting study, the pharmacokinetic (PK) parameter values of generic lurasidone and Latuda® were as follows: the Cmax was 28.84 ± 19.34 ng/ml and 28.22 ± 21.19 ng/ml, respectively; the AUC0-t was 121.39 ± 58.47 h*ng/ml and 118.35 ± 52.24 h*ng/ml, respectively; and the AUC0-∞ was 129.63 ± 63.26 h*ng/ml and 126.59 ± 57.99 h*ng/ml, respectively. The primary pharmacokinetic parameter, Cmax, was assessed for equivalence using reference-scaled average bioequivalence (RSABE), while other parameters (AUC0-t, AUC0-∞) were evaluated using average bioequivalence (ABE). The results indicate that both Cmax and AUC meet the equivalence criteria. In the postprandial study, the PK values of generic lurasidone and Latuda® were as follows: the Cmax was 74.89 ± 32.06 ng/ml and 83.51 ± 33.52 ng/ml, respectively; the AUC0-t was 274.77 ± 103.05 h*ng/ml and 289.26 ± 95.25 h*ng/ml, respectively; and the AUC0-∞ was 302.44 ± 121.60 h*ng/ml and 316.32 ± 109.04 h*ng/ml, respectively. The primary pharmacokinetic parameters (Cmax, AUC0-t, AUC0-∞) were assessed for equivalence using ABE, and both met the equivalence criteria. In the study, lurasidone and Latuda® both exhibited acceptable safety and tolerability. The results displayed that lurasidone and Latuda® were bioequivalent and safe in healthy Chinese participants. Clinical Trial Registry: This trial is registered at chinadrugtrials.org.cn (no.: CTR20191717, date: 2019.08.29).
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Affiliation(s)
- Zhengzhi Liu
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Jinling Xue
- Clinical Research Center, Chia Tai Tianqing Pharmaceutical Group Co., Ltd., Nanjing, China
| | - Qiaohuan Deng
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Yanli Wang
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Lixiu Zhang
- Lung Disease Center, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Lang Liu
- The Clinical Trial Quality Control Center, Ansiterui Medical Technology Consulting Co., Ltd., Changchun, China
| | - Nan Xiao
- Clinical Research Center, Chia Tai Tianqing Pharmaceutical Group Co., Ltd., Nanjing, China
| | - Tianying Chang
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Yingzi Cui
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Yang Cheng
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Guangwen Liu
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Wanhua Wang
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Yannan Zhou
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Wei Yang
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Xinyao Qu
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Jiahui Chen
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Yicheng Zhao
- Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun, China
| | - Zeyu Wang
- Northeast Asia Research Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.
| | - Haimiao Yang
- Phase I Clinical Trial Laboratory, Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China.
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Ng R, El-Den S, Collins JC, Stewart V, McMillan SS, Hu J, Wheeler AJ, O'Reilly CL. Exploring the implementation of a novel community pharmacist-led support service for people living with severe and persistent mental illness. Res Social Adm Pharm 2024; 20:113-122. [PMID: 38467520 DOI: 10.1016/j.sapharm.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Community pharmacists are well-placed to promote and provide mental health medication management services. However, literature evaluating the impact of pharmacy services in supporting people living with severe and persistent mental illness (SPMI) is currently limited. An individualised, goal-oriented pharmacist-led support service that focused on improving the physical and mental health of consumers living with SPMI, namely the PharMIbridge intervention, was provided to consumer participants as part of the PharMIbridge Randomised Controlled Trial (RCT). OBJECTIVE(S) To explore the experiences of the participants who delivered and supported the implementation of the PharMIbridge intervention and propose ideas and supports needed for broader implementation and sustainability of pharmacist-led support services for people living with SPMI. METHODS Interviews and focus group discussions were undertaken with PharMIbridge pharmacists and mentors, respectively. Audio-recordings were de-identified and transcribed verbatim. Data analysis was conducted using an iterative, inductive approach. The key themes identified were furthered divided into subthemes. Subthemes were then mapped to the EPIS (Exploration, Preparation, Implementation and Sustainment) framework. RESULTS Data were collected from one focus group involving six RCT mentors and 16 semi-structured interviews with community pharmacists. Five overarching themes emerged: "Training needs", "Pharmacist integration within the healthcare system", "Environmental factors", "Attitudes and behaviour" and "Pharmacy operations". Twelve subthemes were mapped to EPIS phases "Preparation", "Implementation" and "Sustainment" and EPIS constructs "Outer" context, "Inner" context and "Bridging" factors. CONCLUSION Adequate remuneration and supports to encourage healthcare professional collaboration are necessary to establish and sustain functioning, integrated pharmacy mental health services. A shift in pharmacy business and workflow models is necessary to support community pharmacies to implement mental health services. In addition, there is a need to promote psychological support services to ensure that pharmacists are well supported while delivering pharmacy mental health services.
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Affiliation(s)
- Ricki Ng
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Victoria Stewart
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
| | - Sara S McMillan
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
| | - Jie Hu
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
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Klimentidis D. Effectiveness of clinical pharmacist interventions in optimizing pharmacotherapy for somatic comorbidities in serious mental illness: A clinical audit. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 13:100427. [PMID: 38455672 PMCID: PMC10918557 DOI: 10.1016/j.rcsop.2024.100427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/10/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
Background Clinical pharmacists significantly improve pharmacotherapy outcomes. Patients with serious mental illness (SMI) represent a group particularly vulnerable to medication mismanagement, potentially benefiting from pharmaceutical care targeting medication appropriateness. Objective This study aimed to assess the prevalence of inappropriate medication for somatic comorbidities in SMI patients and to evaluate the impact of clinical pharmacist-led interventions. Methods A pre-post intervention audit involving clinical pharmacist intervention was conducted on SMI patients with somatic comorbidities in a psychiatric clinic in Greece. A comprehensive medication review was undertaken by a clinical pharmacist. The Medicines Appropriateness Index (MAI) and Assessment of Underutilization of medication (AOU) instruments were used to gauge pharmacotherapy appropriateness before and after intervention. Physician acceptance rates and clinical significance were also noted. Statistical analysis employed descriptive and inferential methods, with a significance level set at α = 0.05. Results A total of 58 patients were reviewed. Most patients (75.86%) were being inappropriately treated at baseline, versus 15.52% post-intervention. The pharmacist proposed 107 interventions of which 104 (97.2%) were physician-accepted. Changes in MAI and AOU identified improved medication appropriateness post-intervention [χ2 = 33.029, p < 0.005]. Pharmacist interventions resulted in more (52.1%, n = 25), less (16.7%, n = 8) and no changes (31.2%, n = 15) in the total number of prescribed medicines [median difference:1, p < 0.005]. From 49 medication initiation recommendations, the most prescribed medicines were statins for primary or secondary prevention (n = 21, 42.8%), aspirin for primary or secondary prevention (n = 9, 18.36%) and metformin (n = 4, 8.2%). Conclusion SMI patients had a high prevalence of physical comorbidities, mainly cardiovascular disease, and a high ratio of inappropriate medication treatment. Intervention by a clinical pharmacist significantly improved medication appropriateness and led to the adoption of a new standard of care, to be checked with re-auditing.
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Stewart V, McMillan SS, Hu J, Collins JC, El‐Den S, O'Reilly C, Wheeler AJ. Experiences of goal planning in Australian community pharmacy settings for people experiencing mental illness: A qualitative study. Health Expect 2023; 26:2205-2215. [PMID: 37424358 PMCID: PMC10632654 DOI: 10.1111/hex.13818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/19/2023] [Accepted: 06/30/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Person-centred goal planning is increasingly being incorporated into healthcare interventions. People experiencing severe and persistent mental illnesses (SPMIs) have high levels of co-occurring health conditions, reducing their life expectancy when compared with the general population. As medications are commonly used in the treatment of SPMIs, community pharmacists are well-placed to support the health and wellbeing of this population. OBJECTIVES To examine pharmacists' and service users' experiences of goal planning as a component of a community pharmacy-based health intervention for people experiencing SPMIs (PharMIbridge intervention). METHODS This study utilised a qualitative exploratory approach with an interpretive description method. Semistructured interviews were undertaken with community pharmacists (n = 16) and service user participants (n = 26) who had participated in pharmacist support services for people experiencing SPMIs (PharMIbridge intervention). RESULTS Four themes relating to goal planning were identified. First, goal planning provided purpose and motivation for participation in the intervention. Planning realistic goals was important but often challenging. Both pharmacists and service users highlighted the relational aspects of goal planning and how strong relationships supported positive behaviour change and outcomes. Finally, individualised and flexible approaches were important aspects of the intervention, ensuring goals were meaningful to service users. CONCLUSIONS The findings from this study identified positive outcomes from the inclusion of goal-planning processes in a community pharmacy-based health intervention. Further research regarding tools, strategies or training that could support future goal-planning interventions in primary healthcare is needed. PATIENT OR PUBLIC CONTRIBUTION The PharMIbridge randomised controlled trial research team included lived experience members and was overseen by an expert panel that included members with a lived experience of mental illness and representatives from key organisations. The training provided to pharmacists was co-designed and co-delivered by the researchers and lived experience representatives, and pharmacists were supported by lived experience mentors. Service user participants were invited to participate in the interviews through a number of pathways (e.g., at the completion of the intervention, flyers). Those interested were provided with the full study participant information and provided with a $30 gift voucher at the conclusion of the interview.
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Affiliation(s)
- Victoria Stewart
- Centre for Mental HealthGriffith UniversityNathanAustralia
- Menzies Health Institute QueenslandGriffith UniversityNathanAustralia
- School of Pharmacy and Medical SciencesGriffith UniversityNathanAustralia
| | - Sara S. McMillan
- Centre for Mental HealthGriffith UniversityNathanAustralia
- Menzies Health Institute QueenslandGriffith UniversityNathanAustralia
- School of Pharmacy and Medical SciencesGriffith UniversityNathanAustralia
| | - Jie Hu
- School of Pharmacy and Medical SciencesGriffith UniversityNathanAustralia
| | - Jack C. Collins
- Faculty of Medicine and HealthThe University of Sydney School of Pharmacy, The University of SydneyCamperdownNew South WalesAustralia
| | - Sarira El‐Den
- Faculty of Medicine and HealthThe University of Sydney School of Pharmacy, The University of SydneyCamperdownNew South WalesAustralia
| | - Claire O'Reilly
- Faculty of Medicine and HealthThe University of Sydney School of Pharmacy, The University of SydneyCamperdownNew South WalesAustralia
| | - Amanda J. Wheeler
- Menzies Health Institute QueenslandGriffith UniversityNathanAustralia
- School of Pharmacy and Medical SciencesGriffith UniversityNathanAustralia
- School of Pharmacy, Faculty of Health and Behavioural SciencesUniversity of AucklandAucklandNew Zealand
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Karge RA, Curtain CM, Salahudeen MS. Community Pharmacists' Role in Reducing the Incidence of Cardiometabolic Adverse Drug Events in Schizophrenia: Insights from Mental Health Professionals. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2052. [PMID: 38138155 PMCID: PMC10744378 DOI: 10.3390/medicina59122052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Schizophrenia, a debilitating mental illness, is often associated with significant physical health risks. Many second-generation antipsychotics increase the risk of metabolic syndrome and cardiovascular disease. Community pharmacists are highly accessible and could play a role in monitoring cardiometabolic adverse drug events in people with schizophrenia. However, it remains uncertain whether mental health professionals perceive this as valuable. This study aimed to explore the opinions of mental healthcare professionals regarding the role of community pharmacists in reducing the incidence of cardiometabolic adverse events in people with schizophrenia and their integration into a multidisciplinary mental health team. Materials and Methods: Qualitative semi-structured interviews were conducted with Australian psychiatrists, mental health nurses and mental health pharmacists. Transcription of the interviews underwent thematic analysis using an inductive approach. Results: Eleven mental healthcare professionals from metropolitan and regional areas across Australia were interviewed, leading to the identification of five overarching themes. These themes encompassed the following aspects: the benefits of community pharmacists' involvement in managing cardiometabolic adverse drug events in people with schizophrenia, improving communication pathways with community pharmacists, defining roles and responsibilities for monitoring cardiometabolic parameters and managing adverse cardiometabolic drug events, fostering collaboration between community pharmacists and mental health care professionals, and recognising the acceptance of community pharmacists' integration within a multidisciplinary team. Mental health professionals believed that community pharmacists could play a role in reducing the incidence of cardiometabolic adverse events in schizophrenia. However, they underscored the need for enhanced communication and collaboration pathways with other healthcare professionals, emphasised the importance of more comprehensive mental health first aid training, and identified potential barriers for community pharmacists such as remuneration, workload, and staff resources. Conclusions: Mental health professionals acknowledged the benefits of incorporating community pharmacists into multidisciplinary teams as a strategy to reduce the incidence of adverse events among individuals with schizophrenia. They recognise the competence of community pharmacists in monitoring cardiometabolic adverse events. However, these professionals have also highlighted specific perceived barriers to the complete integration of community pharmacists within these teams. Notably, there are concerns related to remuneration, staff resources, time constraints, acceptance by other healthcare professionals and patients, and the need for improved communication pathways. Addressing these barriers and providing targeted training could facilitate the valuable inclusion of community pharmacists in the comprehensive care of people with schizophrenia.
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Affiliation(s)
| | | | - Mohammed S. Salahudeen
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia; (R.A.K.); (C.M.C.)
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Howe J, Lindsey L. The role of pharmacists in supporting service users to optimise antipsychotic medication. Int J Clin Pharm 2023; 45:1293-1298. [PMID: 37704913 PMCID: PMC10600309 DOI: 10.1007/s11096-023-01630-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/22/2023] [Indexed: 09/15/2023]
Abstract
Pharmacists have a contribution to make in improving optimising medication use for people on antipsychotic medication. The rates of prescribing antipsychotics have increased in England with an 18% rise from 2015 to 2020. People on antipsychotic medication are not treated as equal partners in conversations about their medications. This can leave people to make decisions about their antipsychotic medications without input from their prescribers which can have significant consequences for individuals. Involving people in the decision-making process, as experts on their own condition, has the potential to improve treatment outcomes. The evidence suggests that involving pharmacists in supporting people with serious mental illnesses will lead to improved clinical outcomes. Key areas for pharmacist involvement are providing information, education and counselling on antipsychotic medication and the side effects and reducing polypharmacy especially when antipsychotics are prescribed off license.
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Affiliation(s)
- Jo Howe
- School of Pharmacy, Aston University, Birmingham, B4 7ET, England.
| | - Laura Lindsey
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, Newcastle upon Tyne, NE1 7RU, England
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Wu J, Qiu L, Huang X, Zhou Q, Shen Y. Building a novel self-iterative clinical pharmacist intervention model in psychiatric hospital: Application and evaluation. Asian J Psychiatr 2023; 88:103748. [PMID: 37619417 DOI: 10.1016/j.ajp.2023.103748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/26/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
Clinical pharmacist intervention (CPI) in psychiatric hospital has not been widely developed in China. This study aimed to establish a real-time dynamic self-iterative CPI model in The Affiliated Mental Health Center of Jiangnan University and evaluated its effect. We focused on the running data in 2021 and 2022. The number of interventions, intervention types and intervention strategies were evaluated. In 2021 and 2022, a total of 443 interventions were reported. Among them, 271 (61.17 %) were identified during ward rounds by physicians, pharmacists and nurses. The proportion of CPI through ward rounds and information system gradually decreased while intervention through other ways increased. Meanwhile, there are various of CPI types including adverse drug reactions (26.86 %), therapeutic drug monitoring recommendations (13.32 %), drug usage and dose adjustment (10.61 %) and among them, adverse reactions are the focus of pharmacists' attention. Besides, the intervention strategies of pharmacists mainly concentrated in medication change (18.74 %), medication discontinuation (15.58 %) and dose reduction (12.19 %). In addition, the self-iterative function can continuously optimize the intervention level of clinical pharmacists. Overall, the CPI model established in this study effectively promote pharmacist intervention and accelerate pharmaceutical transformation.
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Affiliation(s)
- Jianhong Wu
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Linghe Qiu
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Xiaoyan Huang
- Wuxi Drug Safety Inspection and Testing Center, Wuxi, Jiangsu, 214151, China
| | - Qin Zhou
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Yuan Shen
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China.
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Evaluation of a training program to support the implementation of a community pharmacist-led support service for people living with severe and persistent mental illness. J Am Pharm Assoc (2003) 2023; 63:807-816.e2. [PMID: 36788042 DOI: 10.1016/j.japh.2023.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND With appropriate training, community pharmacists can support people living with severe and persistent mental illness (SPMI) by identifying and managing medication-related issues and physical health concerns. The Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (RCT) tested the impact of an individualized, pharmacist-led support service for people living with SPMI. OBJECTIVE(S) To evaluate the impact of the PharMIbridge training program on pharmacy participants' knowledge and confidence, as well as stigma and attitudes, in relation to supporting, and providing services to, people living with SPMI; compared to Mental Health First Aid (MHFA) training alone. METHODS Pharmacy staff (n = 140) from 55 community pharmacies across four RCT regions attended face-to-face training. Both intervention group (IG) and comparator group (CG) participants received MHFA training while IG participants received additional PharMIbridge training, involving role-plays and mental health consumer educators (MHCEs). A questionnaire including validated instruments was administered at baseline, after training and after 12 months. Comparative analyses included paired t tests and mixed between/within analysis of variance (ANOVA). RESULTS Pre and post-training surveys were completed by 136 participants, most of which were pharmacists. Both IG and CG participants had significant reductions in stigma (P < 0.001) post-training. IG participants' confidence and knowledge regarding metabolic monitoring significantly improved compared to CG (P < 0.001). IG participants were significantly more confident and comfortable in providing medication counseling, compared to CG participants (P < 0.05). CONCLUSION MHFA training reduced participants' stigma toward mental health. However, the purpose-designed PharMIbridge training program provided pharmacists with additional knowledge and skills to confidently support the physical health care needs of people living with SPMI. The inclusion of role-plays and MHCEs allowed pharmacists to self-reflect and practice skills in safe, supportive environments. Future studies should continue to involve MHCEs in pharmacy training and explore whether these improvements are sustainable.
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Werremeyer A, Frenzel O, Strand MA, Eukel H, Skoy E, Steig J. Improving Community Pharmacist-Delivered Care for Patients With Psychiatric Disorders Filling an Opioid Prescription. Psychiatr Serv 2022; 73:1294-1297. [PMID: 35502518 DOI: 10.1176/appi.ps.202100592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Pharmacists tend to provide care to patients with psychiatric disorders less frequently than to other types of patients, yet patients with psychiatric disorders experience more drug-related problems and use more opioids than those without psychiatric disorders. The Opioid and Naloxone Education (ONE) program equipped pharmacists to screen for opioid misuse and overdose risk and to implement a set of interventions for any patient filling an opioid prescription. Patients with a psychiatric disorder (N=1,980; 24.1% of those screened) were significantly more likely to receive more than one intervention from a ONE program pharmacist than were those without a psychiatric disorder. The use of an objective screening tool and training in stigma reduction and nonjudgmental communication approaches, which are part of the ONE program process, deserve further exploration as ways to increase the frequency of pharmacist-provided education and other critical interventions for patients with psychiatric disorders.
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Affiliation(s)
- Amy Werremeyer
- Department of Pharmacy Practice (Werremeyer, Strand, Eukel, Skoy, Steig) and Department of Public Health (Frenzel), North Dakota State University, Fargo. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Oliver Frenzel
- Department of Pharmacy Practice (Werremeyer, Strand, Eukel, Skoy, Steig) and Department of Public Health (Frenzel), North Dakota State University, Fargo. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Mark A Strand
- Department of Pharmacy Practice (Werremeyer, Strand, Eukel, Skoy, Steig) and Department of Public Health (Frenzel), North Dakota State University, Fargo. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Heidi Eukel
- Department of Pharmacy Practice (Werremeyer, Strand, Eukel, Skoy, Steig) and Department of Public Health (Frenzel), North Dakota State University, Fargo. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Elizabeth Skoy
- Department of Pharmacy Practice (Werremeyer, Strand, Eukel, Skoy, Steig) and Department of Public Health (Frenzel), North Dakota State University, Fargo. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Jayme Steig
- Department of Pharmacy Practice (Werremeyer, Strand, Eukel, Skoy, Steig) and Department of Public Health (Frenzel), North Dakota State University, Fargo. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
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Carpini JA, Sharma A, Kubicki Evans M, Jumani S, Boyne E, Clifford R, Ashoorian D. Pharmacists and Mental Health First Aid training: A comparative analysis of confidence, mental health assistance behaviours and perceived barriers. Early Interv Psychiatry 2022. [PMID: 36203236 DOI: 10.1111/eip.13361] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/01/2022] [Accepted: 09/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pharmacists are aptly positioned to provide first aid-level assistance to patients experiencing a mental health problem or crisis, yet often lack confidence or perceive barriers to intervention. One potential solution is Mental Health First Aid (MHFA) training-an evidence-based psycho-educational programme. This study evaluates MHFA training within pharmacy by (1) assessing pharmacists' perceptions of the prevalence of patients experiencing a mental health-related problem or crisis, (2) investigating whether MHFA is associated with increased confidence, intervention and assistance quality and (3) examining perceived intervention barriers. METHODS Pharmacists working in Australia were surveyed. The survey included validated measures and research objectives were assessed using descriptives and ANOVAs. RESULTS One hundred sixty-one pharmacists were included; 90 MHFA trained and 71 untrained. Overall, 86% of reported encountering at least one patient perceived to be experiencing a mental health problem or crisis in the last year. MHFA trained pharmacists reported being more confident, with notable differences in their confidence to recognize signs, approach and ask someone about suicide. Pharmacists did not intervene ~25% of the time in which a problem/ crisis was identified. When they did intervene, results suggest the assistance was similar in content. Intervention barriers were reported to impede MHFA trained pharmacists significantly less than untrained pharmacists. CONCLUSION Results suggest pharmacists frequently encounter patients experiencing a mental health problem or crisis and that MHFA training may support pharmacists in helping these patients. Future research can utilize experimental methods to provide causal evidence as to the utility of MHFA training for pharmacists and patients.
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Affiliation(s)
- Joseph A Carpini
- Management & Organisations Department, Business School, University of Western Australia, Crawley, Western Australia, Australia
| | - Aakanksha Sharma
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Mikaela Kubicki Evans
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Shaifuldeen Jumani
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Emma Boyne
- Health Promotion Unit, Student Life, University of Western Australia, Crawley, Western Australia, Australia
| | - Rhonda Clifford
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Deena Ashoorian
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
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Farag M, Hoti K, Hughes J, Chalmers L. Impact of a clinical pharmacist on medication safety in mental health Hospital-in-the-Home: a retrospective analysis. Int J Clin Pharm 2022; 44:947-955. [PMID: 35438472 PMCID: PMC9016122 DOI: 10.1007/s11096-022-01409-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/28/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Integration of clinical pharmacists into multidisciplinary Mental Health Hospital-in-the-Home teams is increasing but little is known about the medication safety contribution these pharmacists make. AIM To evaluate whether clinical pharmacist involvement in a Mental Health Hospital-in-the-Home service improved medication safety key performance indicators. METHOD Medical records were retrospectively reviewed of all patients admitted to 2 Western Australian Mental Health Hospital-in-the-Home services from September to November 2015. SITE 1: was a 16-bed service incorporating a clinical pharmacist as part of its multidisciplinary team. SITE 2: was a similarly structured 18-bed service but without clinical pharmacist involvement. The primary outcome measure was completion of medication safety key performance indicators obtained from the Western Australian Government Pharmaceutical Review Policy and mental health-specific best practice guidelines. RESULTS Key performance indicators from Site 1 (n = 75 records), which incorporated a clinical pharmacist, demonstrated significantly (p < 0.001) higher rates of completion of medication reconciliation [65 (87%) versus 17 (29%)], accurate adverse drug reaction list [73 (97%) versus 34 (58%)], accurate discharge medication list [51 (74%) versus 18 (45%)], accurate medication profile [74 (99%) versus 40 (68%)] and medication chart review [74 (99%) versus 0 (0%)] than Site 2 (n = 59). CONCLUSION Integrating a clinical pharmacist into a Mental Health Hospital-in-the-Home program significantly improved achievement of medication safety key performance indicators.
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Affiliation(s)
- Mechaiel Farag
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102 Australia
- North Metropolitan Health Service—Mental Health Pharmacy, Brockway Road, Mount Claremont, WA 6010 Australia
| | - Kreshnik Hoti
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102 Australia
- Division of Pharmacy, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Jeff Hughes
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102 Australia
| | - Leanne Chalmers
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102 Australia
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The role of the clinical pharmacist in mental health hospital-in-the-home: A scoping review. Res Social Adm Pharm 2022; 18:3724-3735. [DOI: 10.1016/j.sapharm.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 11/20/2022]
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