Abstract
Although clinical pharmacy is a discipline that emerged in the 1960s, the question of precisely how pharmacists can play a role in therapeutic optimization remains unanswered. In the field of mental health, psychiatric pharmacists are increasingly involved in medication reconciliation and therapeutic patient education (or psychoeducation) to improve medication management and enhance medication adherence, respectively. However, psychiatric pharmacists must now assume a growing role in team-based models of care and engage in shared expertise in psychopharmacology in order to truly invest in therapeutic optimization of psychotropics. The increased skills in psychopharmacology and expertise in psychotherapeutic drug monitoring can contribute to future strengthening of the partnership between psychiatrists and psychiatric pharmacists. We propose a narrative review of the literature in order to show the relevance of a clinical pharmacist specializing in psychiatry. With this in mind, herein we will address: (i) briefly, the areas considered the basis of the deployment of clinical pharmacy in mental health, with medication reconciliation, therapeutic education of the patient, as well as the growing involvement of clinical pharmacists in the multidisciplinary reflection on pharmacotherapeutic decisions; (ii) in more depth, we present data concerning the use of therapeutic drug monitoring and shared expertise in psychopharmacology between psychiatric pharmacists and psychiatrists. These last two points are currently in full development in France through the deployment of Resource and Expertise Centers in PsychoPharmacology (CREPP in French).
Highlights
Clinical Pharmacy is generally considered to have originated in the USA in the 1960s, while the supervising associations such as the American College of Clinical Pharmacy (ACCP) and the European Society of Clinical Pharmacy (ESCP) were created in 1979 [1,2,3].English speaking countries, and the USA in particular, continue to serve as a benchmark in advancing clinical pharmacy [4]
This level revolves around a network of practitioners, with psychiatric pharmacists and psychiatrists recognized as experts on a targeted domain(s), in order to formalize guidelines tailored to the particularities of each patient and offer advice about the rational use of Therapeutic drug monitoring (TDM) for optimize the prescription of psychotropics
Psychopharmacotherapeutic optimization co-developed by psychiatric pharmacist and psychiatrists and integrated: Medication reconciliation (MedRec), advanced CCI and therapeutic patient education (TPE) is the challenge proposed by the new Resource and Expertise Centers in PsychoPharmacology (CREPP—Centres de Ressources et d’Expertise en Psychopharmacology—in French) [4]
Summary
Clinical Pharmacy is generally considered to have originated in the USA in the 1960s, while the supervising associations such as the American College of Clinical Pharmacy (ACCP) and the European Society of Clinical Pharmacy (ESCP) were created in 1979 [1,2,3]. We propose to carry out below a narrative review of the literature investigating different themes in order to show how clinical pharmacy specializing in psychiatry can respond: (i) to the conventional goals which the discipline sets for itself today (medication reconciliation, therapeutic education); (ii) to new ambitions more oriented towards pharmacotherapeutic optimization and oriented towards privileged collaboration between the psychiatrist (through therapeutic monitoring and shared expertise in psychopharmacology in general), the pharmacist and the patient These latter elements correspond to an ongoing development in clinical pharmacy specializing in psychiatry in France and is currently in full development in this country through the deployment of Resource and Expertise. This integrative model of operation is described at the end of this review
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