title: An expert panel assessment of comprehensive medication reviews for clients of community mental health teams.
abstract: BACKGROUND
  Few studies have investigated strategies to identify and resolve drug-related problems among clients of community mental health teams (CMHTs).
  
  
  OBJECTIVE
  The objective of this study was to evaluate the clinical impact and appropriateness of comprehensive medication reviews for clients of CMHTs.
  
  
  METHODS
  Trained pharmacists conducted interviews (30-45 min each) with clients of CMHTs to identify actual and potential drug-related problems. The pharmacists prepared medication review reports that detailed their findings and recommendations to optimize drug therapy. An expert panel comprising a psychiatrist, general medical practitioner, mental health pharmacist and medication review pharmacist evaluated reviews for 48 clients of 5 CMHTs. Panelists independently assessed review findings, review recommendations, likelihood of recommendation implementation and the overall expected clinical impact.
  
  
  RESULTS
  Two hundred and nine medication review findings and 208 medication review recommendations were evaluated. Panelists agreed with 76% of findings and considered that 81% of recommendations were appropriate. Collectively, 69% of recommendations were considered likely to be implemented. Thirty-seven (77%) reviews were deemed potentially to have a positive clinical impact. The agreement between panelists was statistically significant (P < 0.01) for the assessment of the findings, recommendations and likelihood of recommendation implementation.
  
  
  CONCLUSIONS
  Pharmacists' findings and recommendations to optimize drug therapy were considered appropriate and likely to result in improved clinical outcomes. Comprehensive medication reviews may be a valuable strategy to identify and resolve drug-related problems among clients of CMHTs.
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Gisev
authors.forename: J Simon
authors.initials: JS
authors.lastname: Bell
authors.forename: Claire L
authors.initials: CL
authors.lastname: O'Reilly
authors.forename: Alan
authors.initials: A
authors.lastname: Rosen
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Chen
mesh_terms: D001315:Australia; D003155:Community Mental Health Centers / Q000592:standards / Q000706:statistics & numerical data*; D003157:Community Pharmacy Services / Q000458:organization & administration / Q000592:standards*; D017723:Drug Utilization Review / Q000379:methods / Q000706:statistics & numerical data*; D005104:Expert Testimony / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D010595:Pharmacists / Q000523:psychology / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs