scholarly journals Evaluating the Impact of Pharmacists on Clinical Outcomes and Adherence in Patients with Mental Illness: A Literature Review

2020 ◽  
Vol 2 (01) ◽  
Author(s):  
Dalia Mekeel
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Clinical Trials ◽  
Literature Review ◽  
Clinical Outcomes ◽  
The United States ◽  
Psychotropic Medications ◽  
Depression Symptoms ◽  
Free Text

Purpose: The purpose of this literature review is to investigate the role of pharmacists in improving clinical outcomes and adherence to psychotropic medications in patients with mental illness. The majority of patients tend to stop taking their medications due to the delayed effects or adverse events. It has been established that pharmacists have a positive effect on patients’ clinical outcomes in different chronic disease states other than mental illness. There is also a stigma associated with how comfortable pharmacists are on counseling patients about psychotropic medications. This literature review will evaluate the level of pharmacists’ involvement in treating patients with mental illness as well as strategies used to achieve persistence and compliance with therapy. Methods: A PubMed search was conducted to identify articles related to mental illness and pharmacists. MeSH terms included “antidepressants”, “adherence”, “pharmacists”, and “bipolar disorder”. A free-text search was conducted using the same terms and to search for the most updated American Psychiatric Association practice guidelines. The National Institute of Mental Health database was searched for current mental health statistics in the United States. Collectively, 62 results returned for the MeSh search. This review included studies on adults with mental disorders who were evaluated by pharmacists for adherence and clinical outcomes between the years of 1995-2019. The results of five clinical trials assessing the role of pharmacists in adherence to psychotropic medications will be discussed in this literature review. Results: The clinical trials included in this review showed a statistically significant increase in adherence to psychotropic medications associated with pharmacists’ interventions. The results were not statistically significant for the clinical outcomes in most studies but presented positive improvements in the inpatient and outpatient settings. Canales et al. results showed that patients receiving pharmacists’ interventions in the inpatient setting had >30% improved clinical outcomes measured by different rating scales. The results of Valenstein et al. study conducted at Veteran Affairs clinics were statistically significant for adherence improvement presented by a 25% increase in medication possession ratio. Aljumah et al. clinical trial had a 18% increase in adherence associated with pharmacist interventions. The EMDADER-TAB trial resulted in a statistically significant decrease in ER visits, significant improvement of the depression symptoms, and overall improvement of severity of symptoms. Conclusion: Mental illness should be treated as any other medical condition that requires interventions whenever clinical outcomes are not optimal. Pharmacists have the skills to evaluate clinical symptoms of different psychiatric disorders as well as the knowledge on therapeutic treatments necessary for the optimization of medication use.

Confronting 60 Minutes’ “Imminent Danger”: The Evidence on Schizophrenia and Psychotropic Medications, Violence, and Forced Orders to Treat

2014 ◽  
Vol 16 (1) ◽  
pp. 51-62 ◽  
Author(s):  
Toby T. Watson
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
The United States ◽  
Psychotropic Medications ◽  
Television Show ◽  
Imminent Danger ◽  
The World

Recently, considerable attention has been given to individuals labeled “mentally ill,” with the possibility that they too often go untreated with psychotropic medications and in turn, commit disproportionally higher rates of violence. The world-known television show60 Minutesbroadcasted a special on this topic in the United States on September 29, 2013; however, they created a disturbingly inaccurate picture of those who suffer with what some label as “mental illness.” There are decades of peer-reviewed research demonstrating that individuals diagnosed with severe mental illness, labeledschizophrenia,and given psychotropic medications are in fact less likely to recover from their disorder and more likely to be rehospitalized. Additionally, although mental health commitments, often calledforced orders to treat,are quite common and now being supported more so due to such programming, the research on mental health commitments has not shown they are actually effective.

Breaking Out of the Mainstream: The Evolution of Peer Support Alternatives to the Mental Health System

2008 ◽  
Vol 10 (3) ◽  
pp. 146-162 ◽  
Author(s):  
Alexandra L. Adame ◽  
Larry M. Leitner
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Peer Support ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Health System ◽  
Medical Model ◽  
The United States

The consumer/survivor/ex-patient (c/s/x) movement has been instrumental in the development of a variety of peer-support alternatives to traditional mental health services in both the United States in Canada. This article explores the role of the c/s/x movement in the creation of such alternatives and discusses the various ways peer support is defined and has been put into practice. We also discuss the potential for future alliances and dialogues between progressive mental health professionals and the c/s/x movement as both groups seek ways to reconceptualize mental illness and recovery outside of the medical model paradigm.

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

scholarly journals MyCare study: protocol for a controlled trial evaluating the effect of a community-based intervention on psychosocial, clinical outcomes and hospital admission rates for adults with severe mental illness

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040610
Author(s):  
Renée O'Donnell ◽  
Melissa Savaglio ◽  
Debra Fast ◽  
Ash Vincent ◽  
Dave Vicary ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Controlled Trial ◽  
Community Based ◽  
Admission Rates ◽  
Mental Health Support ◽  
Health Support

IntroductionPeople with serious mental illness (SMI) often fail to receive adequate treatment. To provide a higher level of support, mental health systems have been reformed substantially to integrate mental healthcare into the community. MyCare is one such community-based mental health model of care. This paper describes the study protocol of a controlled trial examining the effect of MyCare on psychosocial and clinical outcomes and hospital admission and duration rates for adults with SMI.Methods and analysisThis is a multisite non-randomised controlled trial with a 3, 6 and 12-month follow-up period. The study participants will be adults (18–64 years of age) with SMI recruited from Hobart, Launceston and the North-West of Tasmania. The treatment group will include adults who receive both the MyCare intervention and standard mental health support; the control group will include adults who receive only standard mental health support. The primary outcome includes psychosocial and clinical functioning and the secondary outcome will examine hospital admission rates and duration of stay. Mixed-effects models will be used to examine outcome improvements between intake and follow-up. This trial will generate the evidence needed to evaluate the effect of a community mental health support programme delivered in Tasmania, Australia. If MyCare results in sustained positive outcomes for adults with SMI, it could potentially be scaled up more broadly across Australia, addressing the inequity and lack of comprehensive treatment that many individuals with SMI experience.Ethics and disseminationThis study has been approved by the Tasmanian Health and Medical Human Research Ethics Committee. The findings will be disseminated to participants and staff who delivered the intervention, submitted for publication in a peer-reviewed journal and shared at academic conferences.Trial registration numberACTRN12620000673943.

Comment: ‘Devining’ The Role of the Consultant Psychiatrist in a Public Mental Health Service

1998 ◽  
Vol 32 (5) ◽  
pp. 612-615 ◽  
Author(s):  
Alan Rosen
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Public Mental Health ◽  
Consultant Psychiatrist ◽  
Persistent Mental Illness ◽  
Public Mental Health Service ◽  
Key Players ◽  
Recovery Program

We admitted to ourselves, …and to our colleagues that we cannot treat people with severe and persistent mental illness as independent practitioners, and asked to be key players on the multidisciplinary team (Extract from A 12-Step Recovery Program for Psychiatrists [1]).

Evaluating psychiatrists’ attitudes and expectations about pharmacists’ role in psychiatry in Jordan

2021 ◽  
Author(s):  
Derar H Abdel-Qader ◽  
Esraa E Al Jomaa ◽  
Jennifer Silverthorne ◽  
Walid Shnaigat ◽  
Salim Hamadi ◽  
...  
Keyword(s):  
Mental Illness ◽  
Logistic Regression ◽  
Response Rate ◽  
Psychotropic Medications ◽  
Descriptive Statistics ◽  
Multivariate Logistic Regression ◽  
Current Role ◽  
Electronic Survey ◽  
Survey Response Rate

Abstract Objectives Evaluating Jordanian pharmacists’ roles in psychiatry from psychiatrists perspective. Methods An electronic survey was sent to 100 psychiatrists registered in the Jordanian Psychiatrists Association. Statistical analysis included descriptive statistics and multivariate logistic regression. Key findings A total of 80 psychiatrists completed the survey (response rate 80%). Most psychiatrists thought that pharmacists are unable to give individuals with mental illness enough time to discuss their medications (62/80, 77.6%) and to monitor psychotropic medications (PM) efficacy (50/80, 62.6%). Around half of respondents thought that, in the future, pharmacists would not be able to suggest PM for patients (42/80, 52.6%), nor changes in PM dosages (37/80, 46.3%). Most psychiatrists emphasized the importance of psychiatric courses to improve pharmacists’ role. Conclusion Although psychiatrists were generally not satisfied with the current role of pharmacists, they had positive expectations about pharmacists’ competency to do certain activities and to assist them in designing drug therapy plans.

A Framework for Systematic Assessment of Clinical Trial Population Representativeness Using Electronic Health Records Data

2021 ◽  
Vol 12 (04) ◽  
pp. 816-825
Author(s):  
Yingcheng Sun ◽  
Alex Butler ◽  
Ibrahim Diallo ◽  
Jae Hyun Kim ◽  
Casey Ta ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Electronic Health Records ◽  
The United States ◽  
Design Stage ◽  
Common Data Model ◽  
Free Text ◽  
Eligibility Criteria ◽  
Health Records ◽  
Electronic Health

Abstract Background Clinical trials are the gold standard for generating robust medical evidence, but clinical trial results often raise generalizability concerns, which can be attributed to the lack of population representativeness. The electronic health records (EHRs) data are useful for estimating the population representativeness of clinical trial study population. Objectives This research aims to estimate the population representativeness of clinical trials systematically using EHR data during the early design stage. Methods We present an end-to-end analytical framework for transforming free-text clinical trial eligibility criteria into executable database queries conformant with the Observational Medical Outcomes Partnership Common Data Model and for systematically quantifying the population representativeness for each clinical trial. Results We calculated the population representativeness of 782 novel coronavirus disease 2019 (COVID-19) trials and 3,827 type 2 diabetes mellitus (T2DM) trials in the United States respectively using this framework. With the use of overly restrictive eligibility criteria, 85.7% of the COVID-19 trials and 30.1% of T2DM trials had poor population representativeness. Conclusion This research demonstrates the potential of using the EHR data to assess the clinical trials population representativeness, providing data-driven metrics to inform the selection and optimization of eligibility criteria.

scholarly journals Holistic Health: Does It Really Include Mental Health?

2006 ◽  
Vol 6 ◽  
pp. 2092-2099 ◽  
Author(s):  
Kimberly K. McClanahan ◽  
Marlene B. Huff ◽  
Hatim A. Omar
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Physical Health ◽  
The United States ◽  
Holistic Health ◽  
Public Perceptions ◽  
The Past ◽  
Mind And Body ◽  
Mental And Physical Health ◽  
The U.S

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

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