(B-049) Effectiveness of Pharmacist-led Tele-Psychiatric Clinic in Managing Drug-Related Problems in Ambulatory Care Settings

Background: Mental illnesses and their treatment are becoming increasingly complex, and telemedicine is a potential solution to improve care for people with mental illness. The management of patients with mental illness, including in a telemedicine setting, is increasingly being handled by clinical pharmacists.

Objectives: To evaluate the effectiveness of clinical pharmacist interventions in managing drug-related problems (DRPs) through telepsychiatry consultation, we sought to determine the rate at which physicians accept clinical pharmacists' recommendations.

Methods: In a psychiatry setting, a retrospective study was conducted at Johns Hopkins Aramco Healthcare, Saudi Arabia, from January 2023 to January 2024 and comprehensively examined all instances of interventions for DRPs facilitated through patient-initiated telepsychiatry encounters with psychiatric clinical pharmacists. Detailed notes from patient charts, documented by the pharmacist in the Electronic Health Record (EHR), were reviewed. These notes provided significant information on psychiatric diagnosis, identified DRPs, and the specific interventions and recommendations proposed by the clinical pharmacist to the attending physician. The Krska classification (a classification system outlined in Scottish practice guidelines for issues found in pharmaceutical care practice) was utilized to classify and analyze the identified DRPs, ensuring a structured and systematic approach to the study’s findings.

Results: Out of 259 pharmacist interventions, 98.5% were accepted by physicians. The predominant intervention involved imparting targeted educational interventions to mitigate issues related to poor medication adherence, representing 16.21% of the total interventions. Substantial efforts were directed towards rectifying inappropriate dosage regimens, accounting for 13.51% of DRPs resolved by the pharmacist. Noteworthy interventions also encompassed identifying and managing potential or suspected adverse reactions, comprising 12.35% of the interventions, and addressing concerns regarding potentially ineffective therapy, constituting 11.59%.

Conclusions: The study highlighted the pivotal role of pharmacists in psychiatric settings, with physicians accepting the majority of their interventions to address DRPs. It also highlighted the diverse spectrum of DRPs encountered, advocating for the expansion of clinical pharmacy services and the integration of pharmacists into the psychiatric care teams. Our findings demonstrate that integrating pharmacists into psychiatric care settings is beneficial. This strategic approach effectively identifies and manages DRPs, ultimately enhancing patient care and treatment outcomes.