{"title":"2021 MHC Awards and Recognition","authors":"A. Vandenberg, Erica A. K. Davis","doi":"10.9740/mhc.2022.04.054","DOIUrl":"https://doi.org/10.9740/mhc.2022.04.054","url":null,"abstract":"","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"1 1","pages":"54 - 56"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83129904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ambitious AAPP vision necessitates bold actions","authors":"M. Cates, Cherry W Jackson","doi":"10.9740/mhc.2022.04.086","DOIUrl":"https://doi.org/10.9740/mhc.2022.04.086","url":null,"abstract":"1 (Corresponding author) Professor and Chair, Department of Pharmacy Practice, Samford University McWhorter School of Pharmacy, Birmingham, Alabama, mecates@samford.edu, ORCID: https://orcid.org/00000002-2960-1921; 2 Professor of Pharmacy, Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, Alabama; Clinical Professor, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, ORCID: https://orcid.org/0000-0003-1213-5407","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"55 1","pages":"86 - 88"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74465982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Silvia, Kelly C. Lee, Gregory H Payne, J. Ho, C. Cobb, Elayne D Ansara, C. Ross
{"title":"Best practice model for outpatient psychiatric pharmacy practice, part 1: Development of initial attribute statements","authors":"R. Silvia, Kelly C. Lee, Gregory H Payne, J. Ho, C. Cobb, Elayne D Ansara, C. Ross","doi":"10.9740/mhc.2022.04.057","DOIUrl":"https://doi.org/10.9740/mhc.2022.04.057","url":null,"abstract":"Introduction A 2019 survey identified significant variability of practice characteristics among outpatient psychiatric pharmacists (OPPs). No published model establishes which attributes constitute best practice for OPPs. By developing a consensus for best practice model attributes, OPPs can work toward consistent, effective patient care. This project aimed to develop attribute statements for a best practice model for OPPs providing direct patient care. Methods Board Certified Psychiatric Pharmacists and American Association of Psychiatric Pharmacists (AAPP) members were questioned using a 5-phase (P1-P5) survey and summit approach. The phases were: P1, broad ideation survey; P2, 10-person summit to develop draft statements; P3, survey of the draft statements for acceptance; P4, summit to resolve review feedback; and P5, survey of AAPP membership to confirm the finalized statements. Results P1 survey results generated a list of 143 possible attributes that informed the P2 summit, which were refined to 28 statements. P3 survey results confirmed at least 70% agreement with each statement. The P4 summit evaluated all P3 survey results and made significant modifications to 4 statements. Informal feedback was sought with other stakeholders, and supporting narratives and references were developed to provide clarity regarding the intent of each statement. Finalized statements and supporting narratives were confirmed in the P5 survey. Discussion The 28 attribute statements were developed over 18 months by gathering input and consensus through multiple modalities, including 3 surveys, 2 summit meetings, and numerous informal feedback requests. The agreement on the attribute statements was consistently high across all phases. The final attribute statements are presented elsewhere in this issue.","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"3 1","pages":"57 - 64"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86391385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Dopheide, Amy Werremeyer, Robert J. Haight, C. A. Gutierrez, Andrew M Williams
{"title":"Positioning psychiatric pharmacists to improve mental health care","authors":"J. Dopheide, Amy Werremeyer, Robert J. Haight, C. A. Gutierrez, Andrew M Williams","doi":"10.9740/mhc.2022.04.077","DOIUrl":"https://doi.org/10.9740/mhc.2022.04.077","url":null,"abstract":"Psychiatric pharmacy continues to grow and look to the future with a focus on helping individuals recover from mental health and substance use disorders. The American Association of Psychiatric Pharmacists (AAPP) considers Board Certified Psychiatric Pharmacist (BCPP) the gold standard credential that all psychiatric pharmacists should attain to demonstrate specialized knowledge and expertise in psychiatry. BCPPs are part of collaborative interprofessional teams and practice in hospitals, clinics, and diverse health systems. Two out of 3 BCPPs practicing in clinics have prescriptive authority. BCPPs improve access, safety, medication adherence, and therapeutic outcomes. Every person with a mental health and substance use disorder should have access to a BCPP providing comprehensive medication management (CMM) and psychotropic stewardship aimed at improving population health. BCPPs are in demand owing to their expertise. AAPP envisions growth and expansion of the BCPP role in many areas including coordinating psychiatric transitions of care and telehealth services, managing long-acting injectable medication clinics, providing pharmacogenomic consultation, conducting clozapine and lithium monitoring, managing medications for substance use disorders, leading medication groups, CNS drug development, research, and provider education. To prepare the workforce, colleges and schools of pharmacy should hire BCPPs for optimal curriculum development, and each student pharmacist should have an opportunity to develop a therapeutic alliance with a person recovering from psychiatric illness. Postgraduate year (PGY) 1 residencies should offer learning experiences in psychiatric pharmacy to prepare residents to enter an expanded number of PGY2 psychiatric pharmacy residencies, ultimately earning their BCPP and being well positioned to improve mental health care.","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"41 1","pages":"77 - 85"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82772417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charles Dorflinger, Heather Carey, Jennifer Roche, PharmD, Bcpp, C. Burant, H. Stewart, Daniel Ayanga
{"title":"CPNP 2020 Annual Meeting Poster Abstracts","authors":"Charles Dorflinger, Heather Carey, Jennifer Roche, PharmD, Bcpp, C. Burant, H. Stewart, Daniel Ayanga","doi":"10.9740/mhc.2020.05.104","DOIUrl":"https://doi.org/10.9740/mhc.2020.05.104","url":null,"abstract":"Type: Work in Progress. Background: Schizophrenia spectrum disorders are a set of chronic and severe mental disorders that affect how a person thinks, feels, and behaves. These disorders affect approximately 4% of patients treated at the Veterans Affairs (VA) Healthcare System. Optimal treatment includes use of an antipsychotic medication. Paliperidone palmitate once-monthly injection (PP1M) is an antipsychotic FDA-approved to treat schizophrenia and schizoaffective disorder. Several studies have raised concerns regarding variable PP1M distribution in obese patients and the potential impact body mass index (BMI) may have on medication effectiveness. This is especially important as patients with schizophrenia are twice as likely to be obese. The purpose of this study is to assess the effectiveness of PP1M in obese compared to non-obese patients. Objectives: (1) Determine the difference in effectiveness, defined as treatment failure, among obese (BMI 30 kg/m) compared to non-obese (BMI 18.5-29.9 kg/m) patients treated at the VA Northeast Ohio Healthcare System (VANEOHS) with PP1M for schizophrenia spectrum disorders. (2) Evaluate treatment failure based on area of injection. Methods: This is a retrospective chart review of patients with a diagnosis of schizophrenia or schizoaffective disorder from January 1, 2014 through January 1, 2019 who received at least one maintenance dose of PP1M at the VANEOHS. The patient list was obtained using the electronic medical record and data will be obtained by chart review. Patients with BMI , 18.5 kg/ m and those who previously trialed PP1M will be excluded. In short, treatment failure is defined as: (1) all cause discontinuation (2) hospital admission for schizophrenia spectrum disorders (3) completed or attempted suicide (4) increased scheduled antipsychotic therapy. Bivariate group comparisons will be completed using ChiSquare test for categorical dependent-outcome variables and t-test for continuous dependent-outcome variables. Logistic regression will be used with obese vs non-obese as the main predictor of interest controlling for covariates of age, race, renal function, and gender predicting treatment failure vs success. The project is approved by local IRB and data analysis will be concluded by February 29, 2020. Outcomes: We will report the number and percent of patients with treatment failure based on BMI categorization and area of injection overall and based on co-variates of interest.","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"20 1","pages":"104 - 206"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85540310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas R. Smith, Marwah H. Dabaja, Marwa J. Farhat
{"title":"Possible varenicline withdrawal-induced akathisia: A case report","authors":"Thomas R. Smith, Marwah H. Dabaja, Marwa J. Farhat","doi":"10.9740/mhc.2019.09.322","DOIUrl":"https://doi.org/10.9740/mhc.2019.09.322","url":null,"abstract":"Akathisia is a relatively common adverse effect that may emerge during treatment with antipsychotics and other medication classes. We present a case of akathisia that may have been induced by the abrupt discontinuation of varenicline and review existing literature related to this phenomenon. A 46-year-old female with a past psychiatric history of bipolar disorder and borderline personality disorder was admitted to the acute psychiatric services department for suicidal ideation after 3 weeks of a new course of varenicline. This was prescribed for smoking cessation and titrated to 1 mg twice daily. Upon admission, the varenicline was discontinued. Roughly 3 days later, the patient began to complain of akathisia. The patient had experienced akathisia previously while taking antipsychotics for her bipolar disorder and was able to recognize its emergence. As the akathisia worsened, propranolol 10 mg 3 times daily was ordered and was effective in relieving her symptoms. A PubMed search using the terms varenicline, akathisia, withdrawal, and discontinuation was conducted. No literature of this phenomenon was found; however, reports of other extrapyramidal symptoms were noted. Considering the timing of varenicline's discontinuation and its mechanism, a pharmacological link between its use and akathisia is possible. Akathisia is a severely uncomfortable sequela of medications that may produce severe outcomes, such as suicidal ideation. In this case, it is possible that the discontinuation of varenicline after 3 weeks of therapy led to akathisia, which was successfully treated with propranolol.","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"18 1","pages":"322 - 325"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78332516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tristyn L. Greiman, Brittani N. Dear, G. Wilkening
{"title":"Adverse outcomes of abrupt switch and discontinuation of acetylcholinesterase inhibitors in dementia with Lewy bodies: Case report and literature review","authors":"Tristyn L. Greiman, Brittani N. Dear, G. Wilkening","doi":"10.9740/mhc.2019.09.309","DOIUrl":"https://doi.org/10.9740/mhc.2019.09.309","url":null,"abstract":"Due to the well-defined risks of abrupt discontinuation of certain psychiatric medications, such as withdrawal and worsening symptoms, guideline recommendations describe evidence-based strategies for tapering some psychiatric medications, such as antidepressants. Despite widespread use of acetylcholinesterase inhibitor (ACHEI) therapy in the management of dementia, guideline recommendations for discontinuation of these therapies are very inconsistent. Specifically, studies and evidence-based recommendations for discontinuing ACHEIs in patients with dementia with Lewy bodies (DLB) are severely lacking. This deficit is problematic in that emerging reports suggest several adverse outcomes, such as worsening cognition and behavioral symptoms, are associated with abrupt switching and discontinuation of ACHEI therapy in this population. A case of rapid cognitive and functional decline following both abrupt switch and discontinuation of donepezil in a patient diagnosed with DLB is presented. A literature review of outcomes following changes in ACHEI therapy in DLB is also presented.","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"81 1","pages":"309 - 314"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83897607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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