Christina Herbert1, Holly Winkler2, Troy A Moore3. 1. Pharmacy Resident, Pharmacy Department, South Texas Veterans Health Care System, San Antonio, Texas; Instructor in Clinical Pharmacy, Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, Texas; Adjoint Assistant Professor, Pharmacotherapy Education & Research Center, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, Christina.Herbert@va.gov. 2. Primary Care Behavioral Health Clinical Pharmacy Specialist, Pharmacy Department, South Texas Veterans Health Care System, San Antonio, Texas; Adjoint Assistant Professor, Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, Texas. 3. Clinical Pharmacy Specialist-Psychiatry, Pharmacy Department, South Texas Veterans Health Care System, San Antonio, Texas; Director, American Society of Health-System Pharmacists-Accredited Postgraduate Year 2 Psychiatric Pharmacy Residency Program, Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, Texas; Co-Director, Interprofessional Advanced Fellowship in Addiction Treatment; Assistant Professor, Division of Community Recovery, Research and Training, Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Abstract
INTRODUCTION: The demand for mental health services has increased as more veterans have been diagnosed with-and sought care for-one or more mental health conditions. Within the South Texas Veterans Health Care System (STVHCS), providers may submit electronic consults (e-consults) to mental health clinical pharmacy specialists for medication review and recommendations. These consults aim to manage veterans with uncomplicated mental health conditions in primary care, making specialty mental health providers more available for those who need such services. Pharmacists have improved outcomes and access to care for conditions such as diabetes and hypertension, but currently, there is limited evidence demonstrating the impact of pharmacists in mental health. METHODS: This quality improvement project assessed the effectiveness of the e-consult service. Information was collected through a retrospective chart review of STVHCS veterans with the corresponding consult note placed in their chart from May 2014 through December 2015. Numbers of recommendations implemented and veterans maintained in primary care were analyzed as markers of effectiveness. Time and cost savings were secondarily explored. RESULTS: A total of 361 consults were submitted for 353 unique patients. Of the 322 patients included in analyses, a total of 301 unique patients (93.5%) were maintained in primary care for at least 3 months. Of the 21 not maintained in primary care, 15 recommendations were implemented; of those maintained in primary care, 271 recommendations were implemented. DISCUSSION: This service improves mental health care-and patient access-by promoting successful management and maintenance of less complicated patients in primary care.
INTRODUCTION: The demand for mental health services has increased as more veterans have been diagnosed with-and sought care for-one or more mental health conditions. Within the South Texas Veterans Health Care System (STVHCS), providers may submit electronic consults (e-consults) to mental health clinical pharmacy specialists for medication review and recommendations. These consults aim to manage veterans with uncomplicated mental health conditions in primary care, making specialty mental health providers more available for those who need such services. Pharmacists have improved outcomes and access to care for conditions such as diabetes and hypertension, but currently, there is limited evidence demonstrating the impact of pharmacists in mental health. METHODS: This quality improvement project assessed the effectiveness of the e-consult service. Information was collected through a retrospective chart review of STVHCS veterans with the corresponding consult note placed in their chart from May 2014 through December 2015. Numbers of recommendations implemented and veterans maintained in primary care were analyzed as markers of effectiveness. Time and cost savings were secondarily explored. RESULTS: A total of 361 consults were submitted for 353 unique patients. Of the 322 patients included in analyses, a total of 301 unique patients (93.5%) were maintained in primary care for at least 3 months. Of the 21 not maintained in primary care, 15 recommendations were implemented; of those maintained in primary care, 271 recommendations were implemented. DISCUSSION: This service improves mental health care-and patient access-by promoting successful management and maintenance of less complicated patients in primary care.