Black Country Partnership Trust Presentation (1)
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Black Country Partnership Trust Presentation (1)
- 1. Role of the Mental Health Pharmacist HelpingImproveTreatmentOutcomes 1 Richard Harris MRPharmS
- 2. Medicines Management Roles • Sound Clinical Grounding mental health patients often suffer poor physical health comorbidity e.g. diabetes • Valuable Resource for patients, carers & health professionals providing drug & health information Pharmacological • Clinical Judgement Screening/accurate/appropriate • Intervention Identifying/resolving issues e.g. concordance • Prescribing/Optimisation Affecting appropriate change-justify-monitor Non- Pharmacological • Health Promotion Pt. engagement-Parity of esteem (barriers to) • Collaboration Shared goals/liaison/research/policy/guidance • Personal Qualities Adaptable - Pro-active - Good communication 2
- 3. Admissions • Meds Reconciliation • DHx-multiple sources • Investigate-challenge -diplomacy • Chart Screen/Clarification • Needs Assessment • Care Planning-capacity?-DoLS? Discharge • Timely medication supply • Transition between care/trust settings • Communication & co-ordination New Meds/Changes • Appropriateness -e.g. formulation/route/brand • Safety-Incident reporting-NPSA high risk list • Supply-checking Rx-non-formulary–PGDs/ESCAs • Monitor: Administration/adherence/response • SE/Toxicity e.g. Lithium Vs Concomitant meds • Clinics-Clozapine/NRT • Optimizing efficacy by provision of EB formulary Information e.g. PLAI guidance/referral • Training/education/health promotion & support Managing Inpatient Pharmaceutical Care Issues 3 Audit- What should we learn? Review-What should we know? Review-What needs to be done?
- 6. References • Improve compliance for mental health patients: they crave more information – Colquhoun, A. The Pharmaceutical Journal, Vol.285,p204-August 1st 2010 • Getting to the bottom of medicines adherence-Torjesen,I . November 2015 The Pharmaceutical Journal, Vol.295,No 7883,online accessed 30/03/2016 • Mental Health Care Project-A framework for pharmacists as partners in mental health care –February 2013-Pharmaceutical Society of Australia • Mental Health Toolkit- Royal Pharmaceutical Society November 2010 • Introduction to Pharmaceutical Care in Mental Health: NHS Education for Scotland (Pharmacy). http://www.nes.scot.nhs.uk/media/415392/nes_mental_pharmacy_-_final.pdf 6
Editor's Notes
- Clinic activities to include: Meds Info + Meds Review/Optimisation+ Side Effect rating/monitoring+ assisting patients to make informed decisions about medicines use-Empowerment & Ownership of patients’ own medicines strategy-Positive outcomes are not just limited to clinical response-concordance and motivation are also key. Teach patients how to recognise signs and symptoms of sub optimal treatments Pace interventions and consultations to individual’s abilities-If withdrawing antipsychotic medication, undertake gradually and monitor regularly for signs and symptoms of relapse COM-B-capability, opportunity & motivation-Developing listening & consultation skills -Small things make a big difference to adherence and medicines optimisation to better understand service user experiences, patient surveys Signposting & supporting rehabilitation in the community- Promoting service user insight and responsibility for own medicines and lifestyle considering wider social issues: E.g. employment by working with community pharmacies & out reach support
- Review: Care planning (Capacity/DoLS), MDT meetings, ESCA (Essential Shared Care Arrangements) Monitoring self administration (Therapeutic & clinical screening Glucose/U&Es LFTs-lithium levels within range (0.6-1mmol/l)-monitoring potential interactions with other co-commitant meds e.g. NSAIDS Reviewing trust policy , trust & national guidance and Formulary guidelines, prepared & resilient to potentially challenging discussions & situations
- Opportunity to recognize potential/actual distress/non adherence/risk taking behaviours and intervene