Magazine article Drug Topics

Pharmacy Reaches out to Patients with Mental Health Issues

Magazine article Drug Topics

Pharmacy Reaches out to Patients with Mental Health Issues

Article excerpt

Pharmacists are among the most trusted and most accessible healthcare professionals, and they improve patient outcomes for many chronic disease states without increasing costs. The 201 1 Report to the U.S. Surgeon General from the Office of the Chief Pharmacist states that "pharmacy practice models can rapidly relieve some of the projected burden of access to quality care, reduce health disparities, and improve overall healthcare delivery."1

Even though community pharmacists are moving from behind the counter to provide more clinical services than ever before, the extra attention may not have reached patients with mental illness yet.

Services gap

A 201 2 survey conducted by the National Alliance on Mental Illness (NAMI) and the College of Psychiatric and Neurologic Pharmacists (CPNP) found that 35% of respondents did not think their pharmacists were interested in their mental health conditions, even though 53% felt they had a strong relationship with their pharmacists.2

In addition a 2010 survey showed that most of the community pharmacists surveyed were more likely to provide services to asthmatic patients than to those with mental illness.3

It has become commonplace for pharmacists to teach wellness classes, offer health screenings, and provide MTM services for a variety of disease states. Though such initiatives are not so widespread in the case of mental illness, some pharmacists across the nation are taking aim at this situation in several different ways.

Patient education

One approach is through patient education. In a fashion similar to teaching healthy eating habits to a diabetic patient, cognitive behavioral therapy (CBT) teaches patients with mood disorders how to improve their moods by breaking the cycle of negative thought patterns.

Although CBT has treated residual depressive symptoms effectively when used as an adjunct to pharmacotherapy, many patients cannot afford the cost of sessions.4

To increase access to care, Barney's Pharmacy, an independent pharmacy in Augusta, Ga., offers a free CBT-based wellness class called "Healthy Minds." The class was created and taught by a pharmacist using CBT reference books. Participants learn to employ techniques such as thought-stopping and recognition of negative thought patterns.

Barry Bryant, RPh, President of Barney's Pharmacy, believes that pharmacists should do more to serve patients with mental illness.

"Most mental health patients are not understood, and they don't understand their illness," said Bryant. "They take their medications, start to feel better, then stop taking their medications. They relapse, and the cycle repeats. No one is reaching out to help these patients in the community setting. We want to show how it's done."

Screening

Wellness classes target patients with a diagnosis, but almost one-third of symptomatic patients never seek medical care.5 Because of this, the American Pharmacists Association Foundation strongly encourages community pharmacists to offer point-of-care screening for major depressive disorder.6 Validated, easy-touse screening tools such as the Patient Health Questionnaire (PHQ) produce reliable results and are widely accepted by the medical community.

Pharmacists at a large grocery chain in Ohio used the PHQ to screen over 3,000 patients; positive scores were referred to a primary care provider. At follow-up, 60% of the referrals resulted in a therapeutic initiation or modification. …

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