Impact of Clinical Pharmacists on Interdisciplinary Mental Health Teams in a Community Setting: A Retrospective Chart Review.

Abstract

Background: Clinical pharmacists play a pivotal role within collaborative care environments, with well-documented contributions on multidisciplinary teams in these settings. Their specific impacts on community mental health and substance use (MHSU) teams remains to be characterized in a publicly funded regional program within Fraser Health.

Objectives: To describe the impact of medication reviews performed by clinical pharmacists and the uptake by prescribers of pharmaceutical interventions recommended by the clinical pharmacists in an ambulatory MHSU setting.

Methods: This study involved a retrospective chart review of 100 patients referred to Fraser Health Community MHSU Pharmacy Services across 20 communities within the Fraser Health Authority in British Columbia.

Results: Clinical pharmacists identified a total of 310 drug therapy problems (DTPs) among the 100 patients. The most common DTPs identified were adverse drug reactions (n = 97, 31%), ineffective drug therapy (n = 68, 22%), unnecessary medications (n = 46, 15%), and the need for additional drug therapy (n = 35, 11%). Prescribers accepted 1 or more of the recommendations made by the clinical pharmacist in 88% (81/92) of the cases with follow-up. More than half (55%, 171/310) of the identified DTPs were resolved within 6 months of the initial pharmacist assessment.

Conclusions: In this study, embedding clinical pharmacists within community MHSU care teams enhanced medication safety and therapeutic optimization, while reducing polypharmacy. Future investigation into the benefits for long-term clinical outcomes is warranted.