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An evaluation of mental health clinical pharmacist independent prescribers within general practice in remote and rural Scotland.

Buist, Elizabeth; McLelland, Rebecca; Rushworth, Gordon F.; Stewart, Derek; Gibson-Smith, Kathrine; MacLure, Andrew; Cunningham, Scott; MacLure, Katie

Authors

Elizabeth Buist

Rebecca McLelland

Gordon F. Rushworth

Derek Stewart

Kathrine Gibson-Smith

Andrew MacLure

Scott Cunningham

Katie MacLure



Abstract

Background: A 12-month pilot was implemented in two general practices in remote and rural Scotland, with patients referred by general practitioners to specialist mental health pharmacist independent prescribers. Objective: The objective was to evaluate the pilot service from the perspectives of the patients and the care team. Methods: The pharmacists routinely recorded patient-specific data of all clinical issues and their actions at the time of each consultation. Further datasets comprised baseline and follow-up Patient Health Questionnaire (PHQ-9) and/or Generalised Anxiety Disorder (GAD-7) rating scales, a patient survey and interviews with members of the care team. Results: Of the 75 patients, two-thirds (n=47, 62.7%) were referred with a diagnosis of mixed depression and anxiety. There were 324 consultations (median 3, IQR 2–5, range 1–14) and 181 prescribing actions. At pilot completion, 34 patients (45.3%) had PHQ-9 and/or GAD-7 scores reduced by 50%. Patient questionnaires and staff interviews generated positive responses. Conclusion: This pilot has provided evidence that specialist mental health pharmacist independent prescribers delivered quality care to patients with diagnoses of moderate to severe depression and/or anxiety. Whilst accepting study limitations, there is potential to translate the pilot model of care to sustained services throughout general practice.

Journal Article Type Article
Publication Date Oct 31, 2019
Journal International Journal of Clinical Pharmacy
Print ISSN 2210-7703
Electronic ISSN 2210-7711
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 41
Issue 5
Pages 1138-1142
Institution Citation BUIST, E. MCLELLAND, R., RUSHWORTH, G.F., STEWART, D., GIBSON-SMITH, K., MACLURE, A., CUNNINGHAM, S. and MACLURE, K. 2019. An evaluation of mental health clinical pharmacist independent prescribers within general practice in remote and rural Scotland. International journal of clinical pharmacy [online], 41(5), pages 1138-1142. Available from: https://doi.org/10.1007/s11096-019-00897-1
DOI https://doi.org/10.1007/s11096-019-00897-1
Keywords Anxiety disorders; Depressive disorders; Independent prescriber; Pharmacist; Primary care; Research evaluation; Scotland
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