Pharmacy, Health Sciences & Exercise Science
Justifying the Implementation of a Collaborative Drug Therapy Management (CDTM) Protocol in an Outpatient Psychiatric Clinic: A Retrospective Chart Review
Document Type
Oral Presentation
Location
Indianapolis, IN
Subject Area
Pharmacy, Health Sciences & Exercise Science
Start Date
10-4-2015 11:30 AM
End Date
10-4-2015 11:45 AM
Sponsor
Laura Ruekert (Butler University)
Description
Background: Patients taking typical and atypical antipsychotic medications are at risk for extrapyramidal side effects and metabolic syndrome, respectively. While psychiatric pharmacists have been shown to improve antipsychotic monitoring through collaborative practice agreements, literature to date is limited.
Objective: The objective of this study was to justify outpatient clinical pharmacy services through a CDTM protocol within Gallahue Mental Health Center in Indianapolis, Indiana.
Methods: A retrospective chart review was performed of patients who visited the center from November 2012 through December 2013. A review was also completed of patients followed at two primary care clinics within Community Health Network, Jane Pauley Primary Care Clinic and Eastside Medical Center, during the same time frame for comparison. Patients included were at least 18 years old and had at least one active antipsychotic prescription. A standardized data collection sheet was used to collect information on frequency and appropriateness of antipsychotic monitoring as recommended by 2004 American Diabetes Association (ADA) guidelines, in consensus with the American Psychiatric Association, the American Association of Clinical Endocrinologists, and the North American Association for the Study of Obesity. Information on patients' medical history, social history, time between clinic visits, and overall antipsychotic use was also collected.
Results: Of those primarily followed in Gallahue, only 1% had any documented fasting blood glucose or lipid panel, 23% had any documented blood pressure, and 53% had any documented weight. This differed greatly from the primary care clinics' results of 63%, 100%, and 92%, respectively. The majority of providers did not adequately document reasons for not performing recommended monitoring.
Conclusion: Substantial discrepancies exist between current and guideline-recommended monitoring practices of patients on antipsychotics, thereby supporting CDTM between clinical pharmacy specialists and providers as a possible solution to improve evidence-based patient care.
Justifying the Implementation of a Collaborative Drug Therapy Management (CDTM) Protocol in an Outpatient Psychiatric Clinic: A Retrospective Chart Review
Indianapolis, IN
Background: Patients taking typical and atypical antipsychotic medications are at risk for extrapyramidal side effects and metabolic syndrome, respectively. While psychiatric pharmacists have been shown to improve antipsychotic monitoring through collaborative practice agreements, literature to date is limited.
Objective: The objective of this study was to justify outpatient clinical pharmacy services through a CDTM protocol within Gallahue Mental Health Center in Indianapolis, Indiana.
Methods: A retrospective chart review was performed of patients who visited the center from November 2012 through December 2013. A review was also completed of patients followed at two primary care clinics within Community Health Network, Jane Pauley Primary Care Clinic and Eastside Medical Center, during the same time frame for comparison. Patients included were at least 18 years old and had at least one active antipsychotic prescription. A standardized data collection sheet was used to collect information on frequency and appropriateness of antipsychotic monitoring as recommended by 2004 American Diabetes Association (ADA) guidelines, in consensus with the American Psychiatric Association, the American Association of Clinical Endocrinologists, and the North American Association for the Study of Obesity. Information on patients' medical history, social history, time between clinic visits, and overall antipsychotic use was also collected.
Results: Of those primarily followed in Gallahue, only 1% had any documented fasting blood glucose or lipid panel, 23% had any documented blood pressure, and 53% had any documented weight. This differed greatly from the primary care clinics' results of 63%, 100%, and 92%, respectively. The majority of providers did not adequately document reasons for not performing recommended monitoring.
Conclusion: Substantial discrepancies exist between current and guideline-recommended monitoring practices of patients on antipsychotics, thereby supporting CDTM between clinical pharmacy specialists and providers as a possible solution to improve evidence-based patient care.