title: Nonpsychiatric medication interventions initiated by a postgraduate year 2 psychiatric pharmacy resident in a patient-centered medical home.
abstract: OBJECTIVE
  Studies have demonstrated the benefits of incorporating comprehensive medication management into primary care, but no study describes the types of nonpsychiatric medication-related interventions provided by a psychiatric pharmacist while providing comprehensive medication management.
  
  
  METHODS
  A chart review of Center for Community Health patients enrolled in the University of Southern California Psychiatric Pharmacy Clinic, Los Angeles, between July 1, 2013, and January 10, 2014, was conducted. Progress notes were reviewed to collect medication recommendations and interventions. The number and types of interventions were compared between groups based on substance abuse history, comorbid medical conditions, number of psychiatric diagnoses, and number of medications. An anonymous survey was distributed to primary care providers (PCPs) regarding perceptions and attitudes toward a postgraduate year 2 psychiatric pharmacy resident's interventions pertaining to nonpsychiatric medications.
  
  
  RESULTS
  177 nonpsychiatric medication interventions were documented. Fifty interventions required PCP approval, and 45% of those were accepted. Having a diagnosis of diabetes (P < .0001), hypertension (P < .0001), gastroesophageal reflux disease (P < .0001), ≥ 9 medications (P < .0001), or ≥ 5 medical diagnoses (P < .0001) were all associated with an increased mean number of interventions. Of the PCPs, 66% viewed the psychiatric pharmacist as a resource for addressing medical interventions by providing drug information. The PCPs were agreeable to having a psychiatric pharmacist provide drug information and monitor the patient but reported mixed opinions on whether a psychiatric pharmacist should comanage nonpsychiatric conditions.
  
  
  CONCLUSIONS
  Psychiatric pharmacists can successfully collaborate with PCPs in primary care clinics to provide comprehensive medication management that optimizes pharmacotherapy for patients with medical and psychiatric conditions. Continued efforts are needed to promote interdisciplinary approaches to provide comprehensive medication management services for patients with both psychiatric and medical disorders.
authors.affiliation: University of Southern California School of Pharmacy, Los Angeles (both authors); and University of Southern California Keck School of Medicine, Los Angeles (Dr Dopheide).
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Williams
authors.affiliation: University of Southern California School of Pharmacy, Los Angeles (both authors); and University of Southern California Keck School of Medicine, Los Angeles (Dr Dopheide).
authors.forename: Julie A
authors.initials: JA
authors.lastname: Dopheide
references.citation: Am J Med. 1996 Apr;100(4):428-37
references.pmid: 8610730
references.citation: Pharmacotherapy. 2003 Sep;23(9):1175-85
references.pmid: 14524649
references.citation: Surg Oncol. 2010 Sep;19(3):155-9
references.pmid: 20106657
references.citation: J Neuroendocrinol. 2001 Dec;13(12):1009-23
references.pmid: 11722697
references.citation: Am J Psychiatry. 2002 Sep;159(9):1584-90
references.pmid: 12202281
references.citation: Prim Care Companion CNS Disord. 2013;15(4):null
references.pmid: 24392254
references.citation: Arch Intern Med. 2004 Jun 28;164(12):1306-12
references.pmid: 15226164
references.citation: J Asthma. 2013 Apr;50(3):260-6
references.pmid: 23294120
references.citation: Med Care Res Rev. 2012 Oct;69(5):602-16
references.pmid: 22653415
references.citation: Health Aff (Millwood). 2013 Nov;32(11):1963-70
references.pmid: 24191087
references.citation: Prim Health Care Res Dev. 2014 Jul;15(3):244-51
references.pmid: 23561004
references.citation: Med Care. 2012 Nov;50(11):997-1001
references.pmid: 23047790
references.citation: JAMA. 2000 Jan 26;283(4):506-11
references.pmid: 10659877
references.citation: J Natl Med Assoc. 2011 Jul;103(7):567-74
references.pmid: 21999031
references.citation: Am J Psychiatry. 2002 May;159(5):860-2
references.pmid: 11986144
references.citation: Am J Pharm Educ. 2010 Nov 10;74(9):163
references.pmid: 21301597
references.citation: Dialogues Clin Neurosci. 2011;13(1):7-23
references.pmid: 21485743
references.citation: J Urban Health. 2011 Aug;88(4):718-23
references.pmid: 21512832
references.citation: J Affect Disord. 2007 Sep;102(1-3):115-23
references.pmid: 17240455
references.citation: Diabetes Care. 2004 Sep;27(9):2154-60
references.pmid: 15333477
references.citation: Am J Med Sci. 2003 Oct;326(4):223-30
references.pmid: 14557739
references.citation: Am J Psychiatry. 1988 Aug;145(8):976-81
references.pmid: 2969199
references.citation: J Manag Care Pharm. 2010 Apr;16(3):185-95
references.pmid: 20331323
references.citation: J Gen Intern Med. 2014 Aug;29(8):1139-47
references.pmid: 24706097
references.citation: J Am Pharm Assoc (2003). 2011 Jan-Feb;51(1):40-9
references.pmid: 21247825
references.citation: Allergy Asthma Clin Immunol. 2013 Nov 11;9(1):45
references.pmid: 24479403
references.citation: Prim Care Companion CNS Disord. 2013;15(5):null
references.pmid: 24511443
references.citation: Subst Abuse Rehabil. 2013 Jan 1;4:3-10
references.pmid: 23378792
references.citation: Am J Manag Care. 2013 May;19(5):344-52
references.pmid: 23781889
references.citation: Psychiatr Clin North Am. 2004 Dec;27(4):675-87
references.pmid: 15550287
references.citation: Ann Intern Med. 2013 Nov 5;159(9):620-6
references.pmid: 24042251
references.citation: Am J Health Syst Pharm. 2008 Feb 1;65(3):229-33
references.pmid: 18216008
references.citation: N Engl J Med. 2010 Dec 30;363(27):2611-20
references.pmid: 21190455
references.citation: Br J Psychiatry. 2009 Jun;194(6):491-9
references.pmid: 19478286
references.citation: Cochrane Database Syst Rev. 2004;(2):CD003689
references.pmid: 15106212