Impact of a specialist mental health pharmacy team on medicines optimisation in primary care for patients on a severe mental illness register: a pilot study
View/
Main article (333.1Kb)
Download
Publication date
2020Keyword
Specialist mental health pharmacySevere mental illness (SMI)
Severe mental illness register
Pharmacists
Primary care
Medicines optimisation
Rights
© 2020 The Authors. Published by BMJ Publishing Group and reproduced in accordance with the publisher's self-archiving policy.Peer-Reviewed
YesMetadata
Show full item recordAbstract
Objective Medication arrangements for patients with severe mental illness (SMI), including schizophrenia and bipolar disorder, can be complex. Some have shared care between primary and secondary services while others have little specialist input. This study investigated the contribution a specialist mental health clinical pharmacy team could make to medicines optimisation for patients on the SMI register in primary care. Research shows that specialist mental health pharmacists improve care in inpatient settings. However, little is known about their potential impact in primary care. Method Five general practice surgeries were allocated half a day per week of a specialist pharmacist and technician for 12 months. The technician reviewed primary and secondary care records for discrepancies. Records were audited for high-dose or multiple antipsychotics, physical health monitoring and adherence. Issues were referred to the pharmacist for review. Surgery staff were encouraged to refer psychotropic medication queries to the team. Interventions were recorded and graded. Results 316/472 patients on the SMI register were prescribed antipsychotics or mood stabilisers. 23 (7%) records were updated with missing clozapine and depot information. Interventions by the pharmacist included clarifying discharge information (12/104), reviewing high-dose and multiple antipsychotic prescribing (18/104), correcting errors (10/104), investigating adherence issues (16/104), following up missing health checks (22/104) and answering queries from surgery staff (23/104). Five out of six interventions possibly preventing hospital admission were for referral of non-adherent patients. Conclusion The pharmacy team found a variety of issues including incomplete medicines reconciliation, adherence issues, poor communication, drug errors and the need for specialist advice. The expertise of the team enabled timely resolution of issues and bridges were built between primary and secondary care.Version
Accepted manuscriptCitation
Raynsford J, Dada C, Stansfield D and Cullen T (2020) Impact of a specialist mental health pharmacy team on medicines optimisation in primary care for patients on a severe mental illness register: a pilot study. European Journal of Hospital Pharmacy. 27(1): 31-35.Link to publisher’s version
http://dx.doi.org/10.1136/ejhpharm-2018-001514Type
ArticleCollections
Related items
Showing items related by title, author, creator and subject.
-
Social policy for people with dementia in England: promoting human rights?This paper discusses whether current UK social policy promotes the human rights of people with dementia living in England. The author focuses on the role of recent legal reforms and key developments in social care policy--notably the Mental Capacity Act 2005 and the 2009 National Dementia Strategy--in facilitating their human rights to liberty and self-determination, particularly a right to choose to live at home. The extent to which the National Dementia Strategy provides access to services and support which provide an alternative to institutional care is critiqued. Whilst recent legislative change has endorsed the rights of people with dementia to liberty and self-determination, it is suggested there is a lack of commitment in government policy more generally to providing access to social care to enable people with dementia to exercise these human rights.
-
Addressing Inclusion: Developing an innovative technology assisted learning package for educators and students for use in a UK Recovery CollegeImproving Inclusion: Developing An Innovative Technology Assisted Learning Package for a UK Recovery College for Mental Health Service Users. Recovery Colleges in the UK represent a new initiative in providing support and psycho-educational interventions for people with mental health difficulties as part of the 'Recovery movement' (Williams, 2016; Perkins and Slade, 2012). Multiple barriers exist for people with mental health difficulties, particularly among ethnic minorities) in accessing such services and include (but are not limited to) -financial problems, difficulties with transport, condition-related difficulties - (e.g. poor motivation, organisational difficulties or feeling unwell) (Memon et al.,2015). To overcome this we put together a collaborative research project with a technology business partners service users and service providers to develop a new technology assisted learning project to ease access to the College's taught sessions. This involved developing sophisticated video-recording and streaming software and hardware that could 64 live-broadcast college sessions to users in their own homes via a variety of hardware platforms. Users could participate in the taught sessions by means of the video/sound interactive software on tablets, mobile devices or their home computer. The innovative features of the TAL package are described, and the impact this facility had on user participation in the college programme evaluated. Particular attention is paid to the development and partnership nature of the project development. The implications for Recovery College and mental health service provider practice is discussed with particular reference to the potential future wider application of TAL packages to promoting access across other domains of mental health care.
-
Mental ill health in nursing and midwifery education. A critical discourse analysisStudents diagnosed with long-term mental health conditions have been the focus of policy development for over a decade. Student mental health is on the increase and universities are legally obliged to make reasonable adjustments for disabled students. Therefore it is crucial that nursing and midwifery education provides an inclusive learning environment, while maintaining fitness to practice standards. The focus of this study was to explore how discourses of mental health, reasonable adjustments and fitness standards influence nursing and midwifery education for students with a mental health condition. Principles of Wodak’s (2001) critical discourse analysis approach, which gives prominence to dominant discourses, their justifications and persuasive nature was utilised. Ten key written texts and 23 semi-structured interviews with students, lecturers and clinical mentors were conducted to acquire the constructions of mental health, reasonable adjustments and fitness requirements. The findings show that the dominant discourses attributed to students experiencing mental ill health were around medicine, difference and blame, all of which reinforced mental health stigma. In addition, mental health discourses within both verbal and written texts were not underpinned by disability discourses, allowing the exclusion of students who disclose mental ill health from accessing reasonable adjustments. In conclusion, students considered to have a mental health label faced discriminatory barriers and legislative and regulatory requirements of equality were not implemented.
