Developing the Inpatient Mental Health Pharmaceutical Assessment and Care Tool (IMPACT) for use by UK mental health pharmacy teams-a modified Delphi study.

Aims: To develop an evidence- and consensus-based patient prioritization tool for use by UK mental health inpatient pharmacy teams.

Methods: A modified-Delphi technique was used to obtain experts' agreement on the content, design and practical use of the patient prioritization tool. Two sequential Delphi questionnaires were prepared based on published evidence concerning risk factors for drug-related problems in mental health hospitals and current prioritization practices used by UK mental health inpatient pharmacy teams. Questionnaires were discussed and agreed upon with a group of 5 stakeholders including 3 mental health pharmacy experts and 2 patient representatives. Pharmacy professionals, psychiatrists and academics were recruited through a previous study and professional networks. Agreement was achieved if ≥75 or ≥85% of the panel rated 6-7 or 5-7 in the Likert scale respectively.

Results: In Delphi 1 questionnaire, 29 experts agreed to include 82 risk indicators in the tool and to categorize patients into 3 risk groups using a traffic light system (red = high-risk, amber = medium-risk, green = low-risk). In Delphi 2 questionnaire, 30 experts agreed on 13 statements guiding practical use of the tool and the preferred frequency of review was every 1-2 day for the high-risk group, every 2-4 days for the medium-risk group and once every working week for the low-risk group.

Conclusion: This study developed the Inpatient Mental Health Pharmaceutical Assessment and Care Tool (IMPACT) for use by UK mental health pharmacy teams. Feasibility and acceptability testing should be carried out to refine the tool and support preparations for formal evaluation of its impact on patient care and service delivery.