Pharmacists at the Forefront: Initiating, Monitoring, and Identifying Candidates for VMAT2 Therapy

In this episode, 'Pharmacists at the Forefront: Initiating, Monitoring, and Identifying Candidates for VMAT2 Therapy,' the expert psychiatry pharmacists explored the following questions:

What is the role of the pharmacist in initiating and monitoring patients on vesicular monoamine transporter 2 (VMAT2) inhibitors?

How can specialty pharmacies help identify patients suitable for VMAT2 therapy early in their disease course?

The panelists examined the multifaceted role pharmacists play in initiating VMAT2 inhibitor therapy, including medication reconciliation, baseline lab assessments, and ensuring patients progress through appropriate titration schedules to reach effective target doses. Jamie Kneebusch and Farah Khorassani discussed the pharmacist's ongoing role in monitoring, including administering Abnormal Involuntary Movement Scale (AIMS) exams, assessing medication adherence, and educating prescribers who may be less familiar with appropriate monitoring practices for these newer agents, such as baseline and follow-up electrocardiograms (ECGs) for patients on high-dose antipsychotics. The panelists also explored innovative models for specialty pharmacies to identify candidates for VMAT2 therapy early, including embedding psychiatric pharmacists within specialty mental health pharmacy clinics to perform assessments and recommend treatment, partnering with residential or inpatient facilities, and leveraging pharmacy students and recently trained pharmacists who already possess the skills to perform AIMS exams.

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, 'Building Lasting Habits: VMAT2 Adherence Strategies and Systematizing TD Screening in Long-Term Facilities,' panelists continue their discussion on tardive dyskinesia and highlight best practices for improving persistence and adherence in patients on VMAT2 therapy, as well as strategies for integrating TD screening and treatment into the routine workflows of long-term facilities such as psychiatric hospitals.