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

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.

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

• Journal Article Type: Article
• Acceptance Date: Aug 22, 2019
• Online Publication Date: Sep 7, 2019
• Publication Date: Oct 31, 2019
• Deposit Date: Sep 24, 2019
• Publicly Available Date: Sep 8, 2020
• Journal: International Journal of Clinical Pharmacy
• Print ISSN: 2210-7703
• Electronic ISSN: 2210-7711
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 41
• Issue: 5
• Pages: 1138-1142
• DOI: https://doi.org/10.1007/s11096-019-00897-1
• Keywords: Anxiety disorders; Depressive disorders; Independent prescriber; Pharmacist; Primary care; Research evaluation; Scotland
• Public URL: https://rgu-repository.worktribe.com/output/522937