Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health.
Clinical pharmacist interventions
Clinical pharmacy in mental health
European society of clinical pharmacy
Mental illnesses and pharmacy
Pharmaceutical services in mental health
Polypharmacy and clinical pharmacy
Psychotropics and clinical pharmacy
Journal
International journal of clinical pharmacy
ISSN: 2210-7711
Titre abrégé: Int J Clin Pharm
Pays: Netherlands
ID NLM: 101554912
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
29
05
2023
accepted:
25
08
2023
medline:
26
10
2023
pubmed:
27
9
2023
entrez:
27
9
2023
Statut:
ppublish
Résumé
A large proportion of the world's disease burden is attributable to mental illnesses. Although effective interventions are available, many patients still have limited access to evidence-based treatments. Aside from access, treatment gaps, including inappropriate medication selection and monitoring, are also routinely recognised. Mental health clinical pharmacists can help address these gaps and enable patients to receive optimised pharmaceutical care, particularly appropriate medication selection and monitoring. The European Society of Clinical Pharmacy (ESCP) Special Interest Group on Mental Health was established to improve standardised service provision in mental health settings across Europe. The Special Interest Group identified significant barriers (predominantly associated with reimbursement and position within the multidisciplinary team) to effective pharmaceutical care amongst those with mental illnesses. This commentary presents recommendations to address these gaps through improved mental health clinical pharmacy service provision.
Identifiants
pubmed: 37755642
doi: 10.1007/s11096-023-01643-4
pii: 10.1007/s11096-023-01643-4
pmc: PMC10600282
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1286-1292Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023. The Author(s).
Références
GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9:137–50.
pmcid: 8776563
doi: 10.1016/S2215-0366(21)00395-3
Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21:655–79.
pubmed: 21896369
doi: 10.1016/j.euroneuro.2011.07.018
World mental health report: transforming mental health for all; 2022. https://www.who.int/publications/i/item/9789240049338 . Accessed 15 May 2023.
COVID-19 Mental Disorders Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700–12.
doi: 10.1016/S0140-6736(21)02143-7
Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med. 2018;48:1560–71.
pubmed: 29173244
doi: 10.1017/S0033291717003336
Kessler RC, Berglund P, Demler O, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095–105.
pubmed: 12813115
doi: 10.1001/jama.289.23.3095
Depression in adults: treatment and management. NICE guideline [NG222]. Published: 29 June 2022. https://www.nice.org.uk/guidance/ng222/chapter/Update-information . Accessed 15 May 2023.
European Society of Clinical Pharmacy (ESCP). https://escpweb.org/ . Accessed 15 Aug 2023.
Stuhec M. Antipsychotic treatment in elderly patients on polypharmacy with schizophrenia. Curr Opin Psychiatry. 2022;35:332–7.
pubmed: 35788124
doi: 10.1097/YCO.0000000000000808
Smolders M, Laurant M, Verhaak P, et al. Adherence to evidence-based guidelines for depression and anxiety disorders is associated with recording of the diagnosis. Gen Hosp Psychiatry. 2009;31:460–9.
pubmed: 19703640
doi: 10.1016/j.genhosppsych.2009.05.011
Stuhec M, Lah L. Clinical pharmacist interventions in elderly patients with mental disorders in primary care focused on psychotropics: a retrospective pre-post observational study. Ther Adv Psychopharmacol. 2021;11:20451253211011010.
pubmed: 34025980
pmcid: 8072848
doi: 10.1177/20451253211011007
Herzog DP, Wagner S, Ruckes C, et al. Guideline adherence of antidepressant treatment in outpatients with major depressive disorder: a naturalistic study. Eur Arch Psychiatry Clin Neurosci. 2017;267:711–21.
pubmed: 28421334
doi: 10.1007/s00406-017-0798-6
Köhler S, Hoffmann S, Unger T, et al. Adherence to guidelines and effectiveness of inpatient treatment for unipolar depression. Int J Psychiatry Clin Pract. 2012;16:103–12.
pubmed: 22141401
doi: 10.3109/13651501.2011.638142
Stuhec M, Zorjan K. Clinical pharmacist interventions in ambulatory psychogeriatric patients with excessive polypharmacy. Sci Rep. 2022;12:11387.
pubmed: 35794225
pmcid: 9259566
doi: 10.1038/s41598-022-15657-x
Aguiar JP, Heitor Costa L, Alves da Costa F, et al. Identification of potentially inappropriate medications with risk of major adverse cardiac and cerebrovascular events among elderly patients in ambulatory setting and long-term care facilities. Clin Interv Aging. 2019;14:535–47.
pubmed: 30880934
pmcid: 6404669
doi: 10.2147/CIA.S192252
Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007;5:345–51.
pubmed: 18179993
doi: 10.1016/j.amjopharm.2007.12.002
Dechanont S, Maphanta S, Butthum B, et al. Hospital admissions/visits associated with drug–drug interactions: a systematic review and meta-analysis. Pharmacoepidemiol Drug Saf. 2014;23:489–97.
pubmed: 24616171
doi: 10.1002/pds.3592
Aguiar JP, Brito AM, Martins AP, et al. Potentially inappropriate medications with risk of cardiovascular adverse events in the elderly: a systematic review of tools addressing inappropriate prescribing. J Clin Pharm Ther. 2019;44:349–60.
pubmed: 30746726
doi: 10.1111/jcpt.12811
Stuhec M, Gorenc K, Zelko E. Evaluation of a collaborative care approach between general practitioners and clinical pharmacists in primary care community settings in elderly patients on polypharmacy in Slovenia: a cohort retrospective study reveals positive evidence for implementation. BMC Health Serv Res. 2019;19:118.
pubmed: 30760276
pmcid: 6375190
doi: 10.1186/s12913-019-3942-3
Janssens B, Petrovic M, Jacquet W, et al. Medication use and its potential impact on the oral health status of nursing home residents in Flanders (Belgium). J Am Med Dir Assoc. 2017;18:809.e1-809.e8.
pubmed: 28733184
doi: 10.1016/j.jamda.2017.06.003
Mann E, Haastert B, Böhmdorfer B, et al. Prevalence and associations of potentially inappropriate prescriptions in Austrian nursing home residents: secondary analysis of a cross-sectional study. Wien Klin Wochenschr. 2013;125:180–8.
pubmed: 23536016
doi: 10.1007/s00508-013-0342-2
Kales HC, Kim HM, Zivin K, et al. Risk of mortality among individual antipsychotics in patients with dementia. Am J Psychiatry. 2012;169:71–9.
pubmed: 22193526
doi: 10.1176/appi.ajp.2011.11030347
Aguiar JP, Alves da Costa F, Egberts T, et al. The association between receptor binding affinity and metabolic side effect profile of antipsychotics and major cardio- and cerebrovascular events: a case/non-case study using VigiBase. Eur Neuropsychopharmacol. 2020;35:30–8.
pubmed: 32409260
doi: 10.1016/j.euroneuro.2020.03.022
Stuhec M, Locatelli I. Age-related pharmacotherapy of attention deficit hyperactivity disorder in Slovenia in children and adolescents: a population-based study. Eur Psychiatry. 2017;42:129–33.
pubmed: 28371725
doi: 10.1016/j.eurpsy.2017.01.002
Tiihonen J, Taipale H, Mehtälä J, et al. Association of antipsychotic polypharmacy vs monotherapy with psychiatric rehospitalization among adults with schizophrenia. JAMA Psychiat. 2019;76:499–507.
doi: 10.1001/jamapsychiatry.2018.4320
Taipale H, Tanskanen A, Mehtälä J, et al. 20-year follow-up study of physical morbidity and mortality in relationship to antipsychotic treatment in a nationwide cohort of 62,250 patients with schizophrenia (FIN20). World Psychiatry. 2020;19:61–8.
pubmed: 31922669
pmcid: 6953552
doi: 10.1002/wps.20699
Taipale H, Mittendorfer-Rutz E, Alexanderson K, et al. Antipsychotics and mortality in a nationwide cohort of 29,823 patients with schizophrenia. Schizophr Res. 2018;197:274–80.
pubmed: 29274734
doi: 10.1016/j.schres.2017.12.010
Howes OD, Vergunst F, Gee S, et al. Adherence to treatment guidelines in clinical practice: study of antipsychotic treatment prior to clozapine initiation. Br J Psychiatry. 2012;201:481–5.
pubmed: 22955007
doi: 10.1192/bjp.bp.111.105833
Taylor DM, Young C, Paton C. Prior antipsychotic prescribing in patients currently receiving clozapine: a case note review. J Clin Psychiatry. 2003;64:30–4.
pubmed: 12590620
doi: 10.4088/JCP.v64n0107
Correll CU, Martin A, Patel C, et al. Systematic literature review of schizophrenia clinical practice guidelines on acute and maintenance management with antipsychotics. Schizophrenia (Heidelberg). 2022;8:5.
doi: 10.1038/s41537-021-00192-x
Farley JF, Hansen RA, Yu-Isenberg KS, et al. Antipsychotic adherence and its correlation to health outcomes for chronic comorbid conditions. Prim Care Companion CNS Disord. 2012;14:PCC.11m01324.
pubmed: 23106028
pmcid: 3466037
Wunderink L, Nieboer RM, Wiersma D, et al. Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiat. 2013;70:913–20.
doi: 10.1001/jamapsychiatry.2013.19
Bole CB, Pišlar M, Mrhar A, et al. Prescribing patterns for inpatients with schizophrenia spectrum disorders in a psychiatric hospital in Slovenia: results of 16-month prospective, non-interventional clinical research. Psychiatr Danub. 2017;29:155–61.
pubmed: 28636573
doi: 10.24869/psyd.2017.155
Rittmannsberger H, Meise U, Schauflinger K, et al. Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics. Eur Psychiatry. 1999;14:33–40.
pubmed: 10572323
doi: 10.1016/S0924-9338(99)80713-5
Aguiar JP, Gama Marques J, Leufkens HGM, et al. Healthcare professionals’ views on the management of medication complexities in the elderly with mental health disorders: a cross-sectional study. Front Psychiatry. 2022;13:885216.
pubmed: 35677869
pmcid: 9168079
doi: 10.3389/fpsyt.2022.885216
Aguiar JP, Bernardo C, Gama Marques J, et al. Identification of a set of patient-related features to foster safe prescribing of specific antipsychotics in the elderly with dementia. Front Psychiatry. 2020;11:604201.
pubmed: 33192746
pmcid: 7661963
doi: 10.3389/fpsyt.2020.604201
Virani A, Crown N. The impact of a clinical pharmacist on patient and economic outcomes in a child and adolescent mental health. Can J Hosp Pharm. 2003;56:158–62.
Mekonnen AB, McLachlan AJ, Brien JA. Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis. BMJ Open. 2016;6:e010003.
pubmed: 26908524
pmcid: 4769405
doi: 10.1136/bmjopen-2015-010003
Javelot H, Gitahy Falcao Faria C, Vandenberghe F, et al. Clinical pharmacy in psychiatry: towards promoting clinical expertise in psychopharmacology. Pharmacy (Basel). 2021;9:146.
pubmed: 34449724
doi: 10.3390/pharmacy9030146
Finley PR, Crismon ML, Rush AJ. Evaluating the impact of pharmacists in mental health: a systematic review. Pharmacotherapy. 2003;23:1634–44.
pubmed: 14695043
doi: 10.1592/phco.23.15.1634.31952
Richardson TE, O’Reilly CL, Chen TF. A comprehensive review of the impact of clinical pharmacy services on patient outcomes in mental health. Int J Clin Pharm. 2014;36:222–32.
pubmed: 24306436
doi: 10.1007/s11096-013-9900-y
Gillespie C, Kleinberg F, Zogas A, et al. Perceptions of clinical pharmacy specialists’ contributions in mental health clinical teams. Ment Health Clin. 2022;12:15–22.
pubmed: 35116208
pmcid: 8788298
doi: 10.9740/mhc.2022.01.015
Finley PR, Bluml BM, Bunting BA, et al. Clinical and economic outcomes of a pilot project examining pharmacist-focused collaborative care treatment for depression. J Am Pharm Assoc. 2011;51:40–9.
doi: 10.1331/JAPhA.2011.09147
Finley PR, Rens HR, Pont JT, et al. Impact of a collaborative care model on depression in a primary care setting: a randomized controlled trial. Pharmacotherapy. 2003;23:1175–85.
pubmed: 14524649
doi: 10.1592/phco.23.10.1175.32760
Adler DA, Bungay KM, Wilson IB, et al. The impact of a pharmacist intervention on 6-month outcomes in depressed primary care patients. Gen Hosp Psychiatry. 2004;26:199–209.
pubmed: 15121348
doi: 10.1016/j.genhosppsych.2003.08.005
Stuhec M, Bratović N, Mrhar A. Impact of clinical pharmacist’s interventions on pharmacotherapy management in elderly patients on polypharmacy with mental health problems including quality of life: a prospective non-randomized study. Sci Rep. 2019;9:16856.
pubmed: 31728029
pmcid: 6856189
doi: 10.1038/s41598-019-53057-w
Hahn M, Reiff J, Hiemke C, et al. Arzneimittelinteraktionen in der Psychiatrie [Drug–drug-interactions in psychiatry]. Psychiatr Prax. 2013;40:154–8.
pubmed: 23345188
doi: 10.1055/s-0032-1332831
Buist E, McLelland R, Rushworth GF, et al. An evaluation of mental health clinical pharmacist independent prescribers within general practice in remote and rural Scotland. Int J Clin Pharm. 2019;41:1138–42.
pubmed: 31493208
doi: 10.1007/s11096-019-00897-1
Stuhec M, Tement V. Positive evidence for clinical pharmacist interventions during interdisciplinary rounding at a psychiatric hospital. Sci Rep. 2021;11:13641.
pubmed: 34211019
pmcid: 8249606
doi: 10.1038/s41598-021-92909-2
Gören JL, Beck SE, Mills BJ, et al. Development and delivery of a quality improvement program to reduce antipsychotic polytherapy. J Manag Care Pharm. 2010;16:393–401.
pubmed: 20635830
Gunterus A, Lopchuk S, Dunn C, et al. Quantitative and economic analysis of clinical pharmacist interventions during rounds in an acute care psychiatric hospital. Ment Health Clin. 2016;6:242–7.
pubmed: 29955477
pmcid: 6007593
doi: 10.9740/mhc.2016.09.242
Hahn M, Roll SC. A new approach to pharmaceutical care: experiences with the “Eichberger” Model in a psychiatric clinic in Germany. Drug Ther perspect. 2012;9:24–6.
Spann G, Austin L, King E. Pharmacists in clozapine clinics improving physical health monitoring. Ment Health Clin. 2022;12:193–8.
pubmed: 35801163
pmcid: 9190272
doi: 10.9740/mhc.2022.06.193
Werremeyer A, Bostwick J, Cobb C, et al. Impact of pharmacists on outcomes for patients with psychiatric or neurologic disorders. Ment Health Clin. 2020;10:358–80.
pubmed: 33224694
pmcid: 7653731
doi: 10.9740/mhc.2020.11.358
Moura L, Steurbaut S, Salvesen Blix H, et al. A cross-sectional survey to map Clinical Pharmacy Education and Practice in Europe. Int J Clin Pharm. 2022;44:118–26.
pubmed: 34498216
doi: 10.1007/s11096-021-01321-3
Committee of Ministers Resolution CM/Res(2020)3 on the Implementation of Pharmaceutical Care for the Benefit of Patients and Health Services. https://go.edqm.eu/ResPhCare20203 . Accessed 22 Apr 2023.
Stuhec M. Clinical pharmacist consultant in primary care settings in Slovenia focused on elderly patients on polypharmacy: successful national program from development to reimbursement. Int J Clin Pharm. 2021;43:1722–7.
pubmed: 34228266
doi: 10.1007/s11096-021-01306-2
Schulz M, Griese-Mammen N, Müller U. Clinical pharmacy services are reimbursed in Germany: challenges of real world implementation remain. Int J Clin Pharm. 2023;45:245–9.
pubmed: 36394784
doi: 10.1007/s11096-022-01492-7
Dreischulte T, van den Bemt B, Steurbaut S, European Society of Clinical Pharmacy. European Society of Clinical Pharmacy definition of the term clinical pharmacy and its relationship to pharmaceutical care: a position paper. Int J Clin Pharm. 2022;44:837–42.
pubmed: 35668277
pmcid: 9393137
doi: 10.1007/s11096-022-01422-7
Alves da Costa F, Stewart D. Universal health coverage for mental health: the contribution of clinical pharmacists. Int J Clin Pharm. 2021;43:1153–4.
pubmed: 34518962
doi: 10.1007/s11096-021-01319-x
Smith SB, Mango MD. Pharmacy-based medication reconciliation program utilizing pharmacists and technicians: a process improvement initiative. Hosp Pharm. 2013;48:112–9.
pubmed: 24421448
pmcid: 3839485
doi: 10.1310/hpj4802-112
Ribeiro N, Mota-Filipe H, Guerreiro MP, et al. Primary health care policy and vision for community pharmacy and pharmacists in Portugal. Pharm Pract (Granada). 2020;18:2043.
pubmed: 32774530
doi: 10.18549/PharmPract.2020.3.2043
Declaration of Astana. World Health Organisation. https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf . Accessed 15 May 2023.
Networking and collaboration: American Association of Psychiatric Pharmacists. https://aapp.org/ . Accessed 15 May 2023.