The pharmacist's role in mental health
Abstract
Given the problematic nature of psychiatric pharmacotherapy and the staggering unmet need for professionals trained to provide such services, it is reasonable to envision an expanding role for pharmacists trained in mental health. Recent movements in pharmacy practice have resulted in innovative patient care services. Little is known about the practices of psychiatric pharmacists with respect to embracing such services. The overall objectives of this thesis were to characterize patient-care services provided by psychiatric pharmacists, to explore the attitudes and expectations of patients with schizophrenia toward pharmacists, and to evaluate discordance between the two perspectives. Two studies were conducted to provide both pharmacist and patient perspectives. In the first study, a web-based questionnaire was distributed to psychiatric pharmacists in the United States. The questionnaire assessed (a) demographics, education, certification, and practice experience, (b) practice environments and patient population, (c) patient-care services provided, and (d) compensation for services. In the second study, patients with schizophrenia completed a brief questionnaire and interview about their attitudes toward pharmacists. This study assessed (a) demographics, pharmacy access, and medication history, (b) perceived pharmacist knowledge, (c) expectations of pharmacists, (d) communication with pharmacists, (e) communication at pharmacies, and (f) pharmacists compared with other professionals. Psychiatric pharmacists (n=186, 14% response rate) practiced primarily on inpatient units (52%) or in outpatient clinics (27%). Psychiatric pharmacists in outpatient clinics had more clinical practice autonomy (p<0.05) and were more likely to be able to initiate, adjust, or discontinue prescription medications on patients' drug regimens (p<0.01 for each). Most were salaried employees of health systems (56%) or academic institutions (25%), and most did not bill for their services (66%). Patients (n=28) perceived pharmacists as knowledgeable about medications and mental illnesses, but predominantly associated them with a dispensing role. They expected pharmacists to dispense medications, act professionally, and provide medication information. Participants indicated pharmacists could improve communication by expressing interest in their well-being. Discordance was found between the services provided by clinical psychiatric pharmacists and the perceptions of pharmacists' roles by patients with schizophrenia. Future research should focus on the impacts of clinical pharmacist-patient relationships in psychiatry and the potential impacts on treatment adherence and outcomes.
Degree
M.S.
Advisors
Hudmon, Purdue University.
Subject Area
Mental health|Pharmacy sciences
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