Can a pharmacy intervention improve the metabolic risks of mental health patients? Evaluation of a novel collaborative service.
BACKGROUND
The pressure on healthcare services worldwide has driven the incorporation of disease state management services within community pharmacies in developed countries. Pharmacists are recognised as the most accessible healthcare professionals, and the incorporation of these services facilitates patient care. In Australia, the opportunity to manage pharmacy patients with mental illness has been underutilised, despite the existence of service models for other chronic conditions. This paper is an independent evaluation of a novel service developed by a community pharmacy in Perth, Western Australia. The service represents collaboration between a nurse practitioner and community pharmacy staff in the management of mental health patients with metabolic risks.


METHODS
We applied practice service standards for Australian community pharmacies to develop an evaluation framework for this novel service. This was followed by semi-structured interviews with staff members at the study pharmacy to explore service processes and procedures. Descriptive analysis of interviews was supplemented with analysis of patients' biometric data. All data were evaluated against the developed framework.


RESULTS
The evaluation framework comprised 13 process, 5 outcomes, and 11 quality indicators. Interview data from eight staff members and biometric data from 20 community-dwelling mental health patients taking antipsychotics were evaluated against the framework. Predominantly, patients were managed by the pharmacy's nurse practitioner, with medication management provided by pharmacists. Patients' biometric measurements comprised weight, blood pressure, blood glucose levels, lipid profiles and management of obesity, smoking, hypertension and diabetes. Positive outcomes observed in the patient data included weight loss, smoking cessation, and improved blood pressure, blood glucose and lipid levels.


CONCLUSIONS
The developed framework allowed effective evaluation of the service, and may be applicable to other pharmacy services. The metabolic clinic met key process, quality and outcomes indicators. The positive patient outcomes may assist in securing further funding.
School of Pharmacy, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
Husna
H
Maulavizada
School of Pharmacy, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Lynne.Emmerton@curtin.edu.au.
Lynne
L
Emmerton
School of Pharmacy, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
Hendrika Laetitia
HL
Hattingh
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D003920:Diabetes Mellitus / Q000451:nursing; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000451:nursing; D050356:Lipid Metabolism / Q000502:physiology; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000378:metabolism / Q000451:nursing; D008659:Metabolic Diseases / Q000517:prevention & control*; D009722:Nurse Practitioners / Q000458:organization & administration; D009765:Obesity / Q000451:nursing; D010594:Pharmacies / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration; D012307:Risk Factors; D016540:Smoking Cessation; D014904:Western Australia
D014150:Antipsychotic Agents; D001786:Blood Glucose
Community pharmacy; Mental health; Metabolic risk; Nurse practitioner; pharmacist