An expert panel assessment of comprehensive medication reviews for clients of community mental health teams

Soc Psychiatry Psychiatr Epidemiol. 2010 Nov;45(11):1071-9. doi: 10.1007/s00127-009-0148-8. Epub 2009 Oct 15.

Abstract

Background: Few studies have investigated strategies to identify and resolve drug-related problems among clients of community mental health teams (CMHTs).

Objective: The objective of this study was to evaluate the clinical impact and appropriateness of comprehensive medication reviews for clients of CMHTs.

Methods: Trained pharmacists conducted interviews (30-45 min each) with clients of CMHTs to identify actual and potential drug-related problems. The pharmacists prepared medication review reports that detailed their findings and recommendations to optimize drug therapy. An expert panel comprising a psychiatrist, general medical practitioner, mental health pharmacist and medication review pharmacist evaluated reviews for 48 clients of 5 CMHTs. Panelists independently assessed review findings, review recommendations, likelihood of recommendation implementation and the overall expected clinical impact.

Results: Two hundred and nine medication review findings and 208 medication review recommendations were evaluated. Panelists agreed with 76% of findings and considered that 81% of recommendations were appropriate. Collectively, 69% of recommendations were considered likely to be implemented. Thirty-seven (77%) reviews were deemed potentially to have a positive clinical impact. The agreement between panelists was statistically significant (P < 0.01) for the assessment of the findings, recommendations and likelihood of recommendation implementation.

Conclusions: Pharmacists' findings and recommendations to optimize drug therapy were considered appropriate and likely to result in improved clinical outcomes. Comprehensive medication reviews may be a valuable strategy to identify and resolve drug-related problems among clients of CMHTs.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Community Mental Health Centers / standards
  • Community Mental Health Centers / statistics & numerical data*
  • Community Pharmacy Services / organization & administration
  • Community Pharmacy Services / standards*
  • Drug Utilization Review / methods
  • Drug Utilization Review / statistics & numerical data*
  • Expert Testimony / methods
  • Female
  • Humans
  • Male
  • Medication Therapy Management / organization & administration
  • Medication Therapy Management / standards
  • Medication Therapy Management / statistics & numerical data
  • Mental Disorders / drug therapy*
  • Middle Aged
  • Pharmacists / psychology
  • Pharmacists / statistics & numerical data*
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / therapeutic use*

Substances

  • Psychotropic Drugs