Pharmacist Skills Support Mental Health Services

November 11, 2014
Rachel Lutz

The broad range of skills pharmacists possess can improve medication adherence and antipsychotic polypharmacy among patients with mental disorders

The broad range of skills pharmacists possess can improve medication adherence and antipsychotic polypharmacy among patients with mental disorders, according to a literature review published in the International Journal of Environmental Research and Public Health.

For their review, the researchers first aimed to parse out the general role of pharmacists in mental health care. Then, they studied the supporting role pharmacists play in quality control for drugs under medication management review, strategies to improve adherence and polypharmacy, and shared decision-making. Finally, the authors considered the barriers and facilitators to the implementation of mental health pharmacy services.

Even though pharmacists are highly accessible to consumers, they traditionally have the most limited access to patients. Nevertheless, the researchers found that pharmacists can provide complementary skills, knowledge, and attitudes to other health care providers in multidisciplinary care, as they are experts in pharmacotherapy. It was also noted that pharmacists in hospital or residential settings have the most access to patients’ clinical charts, which aids communication channels among health care providers.

In addition, the researchers found pharmacists play an important role in mental health screening and risk assessment. Because the stigma surrounding mental health treatment stops many patients from seeking help, pharmacists may be able to recognize their symptoms of depression and other illnesses. In fact, previous research has shown that trained pharmacists with the proper skills and knowledge can identify and support patients with depression. The authors pointed out that pharmacists routinely perform screenings for a number of chronic diseases, but rarely for mental illness.

Since medications are the primary treatment for mental illnesses such as depression, bipolar disorder, and schizophrenia, it logically follows that pharmacists should be able to contribute to care management, the researchers claimed. One prior study suggested that medication review provided by pharmacists reduces the use of potentially inappropriate medicines while offering the benefit of medication counseling, which improves antidepressant medication adherence. In allowing pharmacists to discuss medication regimens with nurses and physicians, another study found an increase in acceptable antidepressant, anxiolytic, and hypnotic medicine use, as well as a decrease in antipsychotic, non-recommended hypnotic, and non-recommended antidepressant medicines.

However, several roadblocks that can prevent pharmacists from reaching this elevated level of care include attitudes, stigma, and skills, which may be relayed to the conflicting business and professional role structures in pharmacy.

“This narrative review has demonstrated that pharmacists have a broad range of skills in medication management, provision of drug information to prescribers, counseling patients about medicines, and facilitating medication adherence strategies in the delivery of mental health care,” the authors concluded. “Understanding and overcoming barriers to the widespread uptake of evidence-based pharmacy services may require specific strategies and training approaches, which include mental health stigma reduction.”