The Imperative of Involving Nurses When Reviewing Psychiatric Medication: a Qualitative Study of Implementing Physician-Led Medication Reviews for Psychiatric Outpatients With Diabetes

IF 3.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Basic & Clinical Pharmacology & Toxicology Pub Date : 2026-06-11 DOI:10.1111/bcpt.70259

Johan Frederik Mebus Meyer Christensen, Elisabeth Mebus Meyer Christensen, Ulla Christensen, Signe Düring, Gesche Jürgens

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Abstract

Background

We previously found that implementing medication reviews by a physician specialised in clinical pharmacology at interdisciplinary conferences with prescribing physicians and nurses led to a relative reduction in the number of drugs and potentially inappropriate prescriptions (PIPs) in psychiatric outpatients with diabetes. Adhering to the framework of health technology assessments (HTAs) and to facilitate direct implementation, we subsequently demonstrated the intervention as cost neutral.

Aim

This study aimed to identify contextual, organisational and interprofessional barriers and facilitators in implementing the intervention focusing on nurses' role at interdisciplinary conferences.

Methods

We conducted semi-structured interviews with available staff and four patients from the intervention group. We conducted a primary thematic analysis with HTA as a framework, while a secondary analysis situated the themes into a contextual understanding.

Results

Interdisciplinary dialogue tailors pharmacological recommendations to patients adhering to clinical pragmatism rather than generic prescription guidelines. It enables professional growth and reciprocal learning and levels out an inherent doctor–nurse hierarchy. However, when conferences were online or hybrid, nurses did not benefit to the same extent and had the feeling of being set aside.

Conclusion

Interdisciplinary medication reviews in psychiatry may improve the clinical relevance of pharmacological decision-making and level out an inherent physician–nurse hierarchy in psychiatry.

Abstract Image

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护士参与精神科药物评核的必要性：医师主导糖尿病精神科门诊患者药物评核实施的质性研究。

背景：我们之前发现，由临床药理学专业医师与开处方的医师和护士在跨学科会议上实施药物审查，导致糖尿病精神科门诊患者的药物数量和潜在不适当处方（pip）的相对减少。为了坚持卫生技术评估框架并促进直接实施，我们随后证明了干预措施的成本中性。目的：本研究旨在确定环境、组织和跨专业障碍和促进因素，以实施干预，重点关注护士在跨学科会议中的角色。方法：采用半结构化访谈法，对有时间的工作人员和干预组的4名患者进行访谈。我们以HTA为框架进行了主要的主题分析，而次要分析则将主题置于上下文理解中。结果：跨学科对话量身定制的药理学建议，以坚持临床实用主义，而不是通用的处方指南。它促进了专业成长和互惠学习，并消除了固有的医生-护士等级制度。然而，当会议是在线的或混合的，护士没有得到同样程度的好处，有被搁置的感觉。结论：精神病学的跨学科药物评价可以提高药理学决策的临床相关性，并消除精神病学固有的医师-护士等级制度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Basic & Clinical Pharmacology & Toxicology 医学-毒理学

CiteScore

5.60

自引率

6.50%

发文量

126

审稿时长

1 months

期刊介绍： Basic & Clinical Pharmacology and Toxicology is an independent journal, publishing original scientific research in all fields of toxicology, basic and clinical pharmacology. This includes experimental animal pharmacology and toxicology and molecular (-genetic), biochemical and cellular pharmacology and toxicology. It also includes all aspects of clinical pharmacology: pharmacokinetics, pharmacodynamics, therapeutic drug monitoring, drug/drug interactions, pharmacogenetics/-genomics, pharmacoepidemiology, pharmacovigilance, pharmacoeconomics, randomized controlled clinical trials and rational pharmacotherapy. For all compounds used in the studies, the chemical constitution and composition should be known, also for natural compounds.