Abstract
AbstractIntroductionThe need for mental health care continues to outpace available providers in the United States. Clinical pharmacists trained in mental health are an available resource for mental health care delivery. To our knowledge, studies have not compared patient outcomes between pharmacist and psychiatrist medication management clinics. The aim of this study is to assess if a significant difference exists between pharmacist and psychiatrist medication management clinics with regard to escalation of care, evidence‐based medication prescribing, and medication adherence.MethodsThis study was a retrospective chart review of patients who received an outpatient prescription from a mental health provider between January 1, 2017 to July 1, 2018 at an urban Veterans Affairs (VA) medical center. The primary outcome was a composite of hospital admissions and emergency department visits due to a psychiatric or substance use condition. Secondary outcomes assessed in this study included treatment aspects related to escalation of care, medication prescribing, and adherence to treatment.ResultsIn this study, 111 patients were included in the pharmacist group and 110 patients in the psychiatrist group with patients matched based on diagnoses. The primary outcome was similar between groups (p = 0.646). The pharmacist clinic had a significantly higher medication possession ratio (p < 0.00001) and laboratory monitoring (p = 0.0015). The psychiatrist clinic had a significantly higher ratio of clinic appointments attended (p = 0.0025).DiscussionPsychiatric pharmacists may serve as an additional resource to provide evidence‐based medication management and improve medication adherence without the need for escalation of care. Increased utilization of psychiatric pharmacists can help improve access to quality care with the psychiatrist shortage.
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