Michelle Harms1, Matthew Haas2, Janel Larew3, Beth DeJongh4. 1. Mental Health Clinical Pharmacy Specialist, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, michelle.harms@va.gov. 2. Mental Health Clinical Pharmacy Specialist, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin. 3. Mental Health Clinical Pharmacy Specialist, Multiple Sclerosis Clinic/Home Base Primary Care Clinical Pharmacy Specialist, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin. 4. Mental Health Clinical Pharmacy Specialist, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin; Assistant Professor of Pharmacy Practice, Concordia University Wisconsin School of Pharmacy, Mequon, Wisconsin.
Abstract
INTRODUCTION: Primary care mental health integration (PCMHI) teams function to improve access and quality of integrative physical and mental health (MH) care through a stepped care treatment approach. The project's primary objective was to evaluate the impact a PCMHI clinical pharmacist made on treatment outcomes and interventions. The secondary objective was to assess medication adherence rates. METHODS: An electronic medical record was used to identify PCMHI patient referrals for medication management during an 8-month period. Patients were included if they were at least 18 years old and referred for medication management of depression, anxiety, posttraumatic stress disorder, or alcohol use disorder. The scores for the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Questionnaire (GAD-7), and the Posttraumatic Stress Disorder Checklist (PCL-C) were recorded at baseline and weeks 4, 8, and 12 during treatment. RESULTS: The analysis included 50 patients, which resulted in a total of 156 contacts between July 2014 and March 2015. The mean change in PHQ-9, GAD-7, and PCL-C scores at week 12 as compared to baseline were a decrease of 10 (95% confidence interval [CI], 6.2-13.8, P < .001), 8 (95% CI, 3.1-12.9, P = .006), and 14.5 (95% CI, -17.3-46.3, P = .109), respectively. A total of 336 treatment interventions were made, and the overall medication adherence rate was 82.9%. DISCUSSION: Medication management, provided by a clinical pharmacist, was associated with a statistically and clinically significant improvement on several MH disorder rating scale scores.
INTRODUCTION: Primary care mental health integration (PCMHI) teams function to improve access and quality of integrative physical and mental health (MH) care through a stepped care treatment approach. The project's primary objective was to evaluate the impact a PCMHI clinical pharmacist made on treatment outcomes and interventions. The secondary objective was to assess medication adherence rates. METHODS: An electronic medical record was used to identify PCMHI patient referrals for medication management during an 8-month period. Patients were included if they were at least 18 years old and referred for medication management of depression, anxiety, posttraumatic stress disorder, or alcohol use disorder. The scores for the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Questionnaire (GAD-7), and the Posttraumatic Stress Disorder Checklist (PCL-C) were recorded at baseline and weeks 4, 8, and 12 during treatment. RESULTS: The analysis included 50 patients, which resulted in a total of 156 contacts between July 2014 and March 2015. The mean change in PHQ-9, GAD-7, and PCL-C scores at week 12 as compared to baseline were a decrease of 10 (95% confidence interval [CI], 6.2-13.8, P < .001), 8 (95% CI, 3.1-12.9, P = .006), and 14.5 (95% CI, -17.3-46.3, P = .109), respectively. A total of 336 treatment interventions were made, and the overall medication adherence rate was 82.9%. DISCUSSION: Medication management, provided by a clinical pharmacist, was associated with a statistically and clinically significant improvement on several MH disorder rating scale scores.
Entities:
Keywords:
anxiety; care management; depression; pharmacist; posttraumatic stress disorder; primary care mental health integration
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