Effectiveness of a pharmacist-led tele-psychiatric clinic in managing drug-related problems

BACKGROUND: The study aimed to evaluate the effectiveness of telepsychiatry combined with the expertise of psychiatric clinical pharmacists in identifying and addressing drug-related problems (DRPs) associated with psychotropic medications. Additionally, the research assessed physicians' acceptance of pharmacists' recommendations for managing these DRPs.

METHODS: A cohort retrospective study was conducted at a leading tertiary care hospital in Saudi Arabia spanning from January 2023 to January 2024 in a psychiatry setting. The study comprehensively examined all instances of interventions for DRPs facilitated through patient-initiated telepsychiatry encounters with psychiatric clinical pharmacists. Detailed and meticulously recorded notes from patient chart reviews, documented by the pharmacist in the Electronic Health Record (EHR), during each encounter, were reviewed. These notes provided significant information on psychiatric diagnosis, identified DRPs and the specific interventions and recommendations proposed by the clinical pharmacist to the attending physician. The Krska classification was utilised to classify and analyse the identified DRPs, ensuring a structured and systematic approach to the study's findings.

RESULTS: A total of 259 pharmacist interventions were made, and the results revealed a remarkably high acceptance rate of 98.5% among physicians. The most common intervention (16.21%) involved targeted education to improve medication adherence. Additionally, substantial efforts were directed towards rectifying inappropriate dosage regimens, accounting for 13.51% of DRPs resolved by the pharmacist. Noteworthy interventions also encompassed the identification and management of potential or suspected adverse reactions, comprising 12.35% of the interventions, along with interventions addressing concerns regarding potentially ineffective therapy, which constituted 11.59%.

CONCLUSION: The study underscores the critical role of pharmacists in psychiatric care, with high physician acceptance of their interventions. The diverse range of DRPs highlights the need to expand clinical pharmacy services and integrate pharmacists into psychiatric teams. Our findings clearly demonstrate that integrating pharmacists into psychiatric care settings is beneficial. This approach enhances DRP identification and management, ultimately enhancing patient care and treatment outcomes.