Our commitment to patient care

Abstract

The section of the manifesto addressing “our commitment to patient care” is what I believe to be the core of pharmacy practice, regardless of specialty. As psychiatric pharmacists, we have a great responsibility in providing health care to a population that in many areas is underserved by their community. These patients often hesitate to seek assistance, whether due to the stigma of mental illness and lack of insight, access to services, or trust in others. Psychiatric and neurologic specialty pharmacists must establish themselves as compassionate, respectful healthcare providers that will provide prescribers and patients with the highest quality of service. With the provision of medication therapy management services becoming the standard of care, our specialty must take this opportunity to screen patients who may not be receiving adequate assistance. We must be able to not only make medication interventions to improve their care, but also provide resources to empower and assist our patients on their path to a better quality of life.Patient education is, therefore, a crucial factor in assisting this population. By educating patients regarding their medication and mental illness, we offer them the opportunity to be active partners in their health care. In accomplishing this, we can encourage treatment adherence. By promoting adherence, psychiatric and neurologic pharmacists can achieve improved patient outcomes.12 As pharmacists, we are in a unique position to provide this information to patients and their families, and are able to address concerns that the physician may not have the time to discuss. Additionally, the patient may feel more comfortable addressing these concerns with us, rather than with their physician. In my experience, patients have told me that the pharmacist appears less threatening to them, so they are willing to share certain information or previous experiences with us that they may hesitate to share with their physician. We may also simply be more accessible to the patient, and have more time to dedicate to them than their physician.Central to providing this level of quality care is to remember to treat the patient as a whole person. As a specialized pharmacist, it may be difficult to maintain a level of proficiency in other areas of pharmacy. We may get so involved with performing psychiatric consults that sometimes we may forget or become uncomfortable in addressing non-psychiatric/neurologic issues. At times we may pass the baton to another clinical pharmacist to assess those potential problems. When performing clinical interventions for our patients, we should not be limiting ourselves to the psychiatric regimens. As clinical pharmacists, we should be able to assess the patient's entire regimen and be able to make recommendations to other aspects of their pharmacological treatments. The frequency of non-psychiatric clinical interventions by psychiatric pharmacists has not been quantified in recent literature; however, this should ideally be occurring on a regular basis. As psychiatric/neurologic pharmacists, we should possess the clinical knowledge to address most medication-related concerns for a patient, with the added benefit of being specialized in psychiatric care; not limited to solely providing psychiatric consults and medication management. Certainly, there will be cases in which we need to consult with a colleague with more expertise in a certain area of pharmacy. However, we should have a general knowledge base over pharmacy, and use our clinical judgment for deciding when to reach out to our colleagues, rather than automatically passing the concern on when it is not psychiatry/neurology related.One potential remedy to this issue may be to consider board certification in pharmacotherapy, in addition to psychiatric pharmacy. This may ensure competence in all areas of pharmacy and provide us with a greater arsenal with which to care for our patients. It would also encourage us to stay up to date with current guidelines and research in areas outside of psychiatry and/or neurology. For those hesitant to take this on, perhaps attending pharmacy meetings (e.g., journal clubs, continuing education) dedicated to other areas of pharmacy may be an appropriate avenue to pursue data on new developments in these areas.In our efforts to be committed to patient care, psychiatric and neurologic pharmacists must strive to be proficient in the use of a wide variety of medications. Clinical pharmacists must look at our patients comprehensively, and make interventions accordingly. It is our duty to provide them with a high level of care, and to do whatever it takes to stay abreast of advancements in the field of pharmacy in general, in addition to our specialty of psychiatry or neurology. We must be compassionate, knowledgeable, respectful, and provide our patients with the tools they need to rise above their mental illness and take control of their lives.