Psychiatric pharmacists have enaged in team-based care for 40+ years, and the research is overwhelmingly positive about their contribution to access, outcomes and cost. Given the diverse practice models in use today, you can find results of pharmacist contributions to most types of mental health practice settings. Below are some papers developed recently by AAPP committees and task forces that illustrate the broad impact that psychiatric pharmacists are having across the health care system.
With its placement in Psychiatric Services, the American Psychiatric Association’s peer-reviewed journal, this article is designed to educate an interprofessional audience about Board-Certified Psychiatric Pharmacists (BCPPs), their educational training, and their expertise in medication management for people living with psychiatric disorders, including substance use disorders. Along with describing the settings and roles in which BCPPs practice, the article discusses current policies that limit BCPP involvement in behavioral health care and proposed solutions to support the role of BCPPs in addressing behavioral health workforce shortages.
With a national emergency in child and adolescent psychiatry (CAP), this critical and timely article describes the compelling outcomes being achieved in CAP through interprofessional collaboration among child and adolescent psychiatrists, primary care providers, and BCPPs, among other team members. The article addresses the success of BCPPs in decreasing polypharmacy, increasing medication adherence and knowledge, and enhancing patient outcomes in children and adolescents.
Aligned with ASHP’s Pharmacy Forecast, this commentary details the increasing need for mental health services and the importance of growing the number of psychiatric pharmacists. The commentary details the important and varied roles psychiatric pharmacists play and urges pharmacists to consider the meaningful, rewarding work that can be gained through the provision of team-based care in a high need therapeutic area. It additionally encourages employers to offer mental health services and support pharmacist obtainment of the BCPP credential.
This is a description for public health professionals of roles related to SDOH. Pharmacists play a key role in identifying and mitigating SDOH for patients with psychiatric disorders. Using Healthy People 2030 as a framework, the impact of community pharmacists, clinical pharmacists, and psychiatric pharmacists can be detected across a spectrum of key SDOHs. An especially useful table is the crosswalk between various SDOHs and indication, effectiveness, safety, and adherence. Continue reading.
This is a description for pharmacists of the vision for the specialty. 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. The paper also includes recommendations to prepare the workforce. Continue reading.
This is a description for non-pharmacists of general roles. BCPPs currently assist in expanding care access, improving medication-related outcomes, and reducing health care costs by working collaboratively with physicians and other health care providers. However, they are often underutilized, which results in lost opportunities to better address the needs of persons with psychiatric or substance use disorders and to meet these needs in a timely manner. Five key areas in which BCPPs provide evidence-based care and could be more extensively used as a collaborative solution are: opioid use disorder, antipsychotic use among children, long-acting injectable antipsychotics, clozapine use, and transitions of care and care coordination. Continue reading.
Based on common traits of various effective medication management strategies, this article develops a framework for psychotropic stewardship programs (PSPs). The ultimate goal is that every patient with a psychiatric disorder, including substance use disorders, will have their medication therapy reviewed, optimized, and managed by a psychiatric pharmacist as part of a psychotropic stewardship team. In short, intentional efforts to have a Board Certified Psychiatric Pharmacist (BCPP) provide Comprehensive Medication Management (CMM) services to patients with psychiatric disorders will improve access, outcomes, and cost. Continue reading.
A 2019 survey identified significant variability of practice characteristics among outpatient psychiatric pharmacists (OPPs). No published model established which attributes constitute best practice for OPPs. By developing a consensus for best practice model attributes, outpatient psychiatric pharmacists can work toward consistent, effective patient care. This project ultimately developed 28 attribute statements for a best practice model for those outpatient psychiatric pharmacists providing direct patient care. Continue reading.
Psychiatric pharmacists experience a significant variability in their prescriptive authority. Their demographics reflect changes in residency accreditation and increased numbers of psychiatric residencies within VA facilities. Those with prescriptive authority reported treating psychiatric and medical conditions, creating added value. Expansion of psychiatric pharmacist services, including prescriptive authority, should be considered as a viable addition to the care provided to patients with mental illness, especially in areas where there is a shortage of such services. Continue reading.
The current practice of psychiatric pharmacy is incredibly varied in terms of practice setting, activities performed, and services provided. This study is notable for being the first comprehensive survey of current psychiatric pharmacy practice in the United States. It illuminates the wide variety of practice settings that currently employ psychiatric pharmacists to improve access, outcomes, and cost. Continue reading.
The Systematic Literature Review Committee of the American Association of Psychiatric Pharmacists was formed and tasked with compiling a comprehensive database of primary literature highlighting the impact of psychiatric pharmacists on patient-level outcomes.
With 4270 articles reviewed, this article represents the most extensive and comprehensive evaluation of primary literature to date, highlighting the impact of psychiatric pharmacists on patient-level outcomes. The database underscores the wide range of BCPP clinical practice settings, as well as the varied outcomes used to measure the impact on the quadruple aims of health care.
AAPP has developed the Core Outcome Set for Psychiatric Pharmacists (COS-PP) to help define psychiatric pharmacists' support of the interdisciplinary team in addressing the quadruple health care aims. Use of standardized outcomes across practice sites will allow aggregation of data on the impact of psychiatric pharmacists on patient care. Complementing the Core Outcome Set Toolkit, this article details how the Core Outcome Set Committee, following guidelines from the Core Outcome Measures in Effectiveness Trials (COMET) initiative, used literature, a survey of psychiatric pharmacists, and a summit to achieve consensus on the final COS-PP consisting of 21 outcomes grouped according to the quadruple health care aims: better care, reduced health care costs, improved patient experience, and improved clinician well-being.
In 2020, AAPP conducted a literature review to update the list of key studies from the 2015 paper. The number of projects illustrates the expansion of psychiatric pharmacy practice and research since the previous paper was published. This paper provides summaries of 64 additional studies 1/1/2014-6/1/2019, as well as additional analysis of the outcomes. Continue reading.
In 2015, AAPP published this major paper that reviews the literature on psychiatric pharmacists' value up to 2014. Including summaries of 28 high-quality studies, it illustrates the value of psychiatric pharmacists in many different settings. This paper serves as a primer on psychiatric pharmacists by also reviewing the growing need for psychiatric pharmacists, the unique training and experience of the psychiatric pharmacist, and comprehensive medication management. Continue reading.