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PATIENT-CENTRED CLINICAL PHARMACY AND MEDICINES INFORMATION SERVICE ON A PSYCHIATRIC INTENSIVE CARE UNIT
European Statement
Clinical Pharmacy Services
Author(s)
Caroline Hynes, Dolores Keating
Why was it done?
Psychiatric intensive care is for patients who are in an acutely disturbed phase of a serious mental disorder. Psychotropic medicines play a pivotal role in the treatment of these disorders which is why the pharmacist is a key part of the patient care team. The introduction of a designated pharmacist to address not only the clinical needs of the PICU team but also the medicines information needs of the patient was essential to optimise patient outcomes.
What was done?
A liaison pharmacist was assigned to the psychiatric intensive care unit (PICU) to provide both a clinical pharmacy service including regular medication chart review and development of patient-centred clinical guidelines, and to provide medicines information and support directly to patients.
How was it done?
The main obstacle to the introduction of this initiative was establishing a relationship with patients, as visible pharmacist interventions were new to patients on the PICU. In order to overcome this obstacle, the pharmacist was required to be present on the unit and regularly meet patients to enquire about their experience of taking medicine for their mental health and provide information as required.
What has been achieved?
• The pharmacist hosts a weekly medicines information group on the unit where; medicines are discussed openly, patients are provided with medicines information leaflets and medicines charts detailing all of their current medicines and what they are for, and those taking antipsychotics are systematically assessed for side-effects
• The pharmacist carries out a regular clinical pharmacy review where medication charts are clinically assessed and any interventions are relayed to the relevant consultant psychiatrist and registrar
• The pharmacist develops new patient-centred guidelines for use on the PICU e.g. Guidelines on the pharmacological prevention and management of violence or aggressive behaviour
What next?
By having an awareness of the patient experience of their medicine (especially side-effects) through regular contact at the medicines information groups, the pharmacist is in a position to provide more informed clinical advice to the PICU team. This patient-centred approach to the clinical pharmacy service could be transferred to any healthcare setting where the pharmacist can link directly with both patients and their multidisciplinary team.