BACKGROUND: Few studies have investigated strategies to identify and resolve drug-related problems among clients of community mental health teams (CMHTs). OBJECTIVE: The objective of this study was to evaluate the clinical impact and appropriateness of comprehensive medication reviews for clients of CMHTs. METHODS: Trained pharmacists conducted interviews (30-45 min each) with clients of CMHTs to identify actual and potential drug-related problems. The pharmacists prepared medication review reports that detailed their findings and recommendations to optimize drug therapy. An expert panel comprising a psychiatrist, general medical practitioner, mental health pharmacist and medication review pharmacist evaluated reviews for 48 clients of 5 CMHTs. Panelists independently assessed review findings, review recommendations, likelihood of recommendation implementation and the overall expected clinical impact. RESULTS: Two hundred and nine medication review findings and 208 medication review recommendations were evaluated. Panelists agreed with 76% of findings and considered that 81% of recommendations were appropriate. Collectively, 69% of recommendations were considered likely to be implemented. Thirty-seven (77%) reviews were deemed potentially to have a positive clinical impact. The agreement between panelists was statistically significant (P < 0.01) for the assessment of the findings, recommendations and likelihood of recommendation implementation. CONCLUSIONS: Pharmacists' findings and recommendations to optimize drug therapy were considered appropriate and likely to result in improved clinical outcomes. Comprehensive medication reviews may be a valuable strategy to identify and resolve drug-related problems among clients of CMHTs.
BACKGROUND: Few studies have investigated strategies to identify and resolve drug-related problems among clients of community mental health teams (CMHTs). OBJECTIVE: The objective of this study was to evaluate the clinical impact and appropriateness of comprehensive medication reviews for clients of CMHTs. METHODS: Trained pharmacists conducted interviews (30-45 min each) with clients of CMHTs to identify actual and potential drug-related problems. The pharmacists prepared medication review reports that detailed their findings and recommendations to optimize drug therapy. An expert panel comprising a psychiatrist, general medical practitioner, mental health pharmacist and medication review pharmacist evaluated reviews for 48 clients of 5 CMHTs. Panelists independently assessed review findings, review recommendations, likelihood of recommendation implementation and the overall expected clinical impact. RESULTS: Two hundred and nine medication review findings and 208 medication review recommendations were evaluated. Panelists agreed with 76% of findings and considered that 81% of recommendations were appropriate. Collectively, 69% of recommendations were considered likely to be implemented. Thirty-seven (77%) reviews were deemed potentially to have a positive clinical impact. The agreement between panelists was statistically significant (P < 0.01) for the assessment of the findings, recommendations and likelihood of recommendation implementation. CONCLUSIONS: Pharmacists' findings and recommendations to optimize drug therapy were considered appropriate and likely to result in improved clinical outcomes. Comprehensive medication reviews may be a valuable strategy to identify and resolve drug-related problems among clients of CMHTs.
Authors: Jeffrey M Rothschild; Klaus Mann; Carol A Keohane; Deborah H Williams; Cathy Foskett; Stanley L Rosen; Linda Flaherty; James A Chu; David W Bates Journal: Gen Hosp Psychiatry Date: 2007 Mar-Apr Impact factor: 3.238
Authors: Thomas R E Barnes; Carol Paton; Mary-Rose Cavanagh; Elizabeth Hancock; David M Taylor Journal: Schizophr Bull Date: 2007-05-04 Impact factor: 9.306
Authors: Klaus Mann; Jeffrey M Rothschild; Carol A Keohane; James A Chu; David W Bates Journal: World J Biol Psychiatry Date: 2008 Impact factor: 4.132
Authors: Amary Mey; Jane L Fowler; Kathy Knox; David H K Shum; Jasmina Fejzic; Laetitia Hattingh; Denise McConnell; Amanda Wheeler Journal: Community Ment Health J Date: 2013-01-10