A multi-perspective evaluation of specialist mental health clinical pharmacist prescribers practising within general practices in NHS Highland 

Authors 

E Buist, R McLelland, G Rushworth  - NHS Highland

K MacLure, D Stewart, K Gibson-Smith, A MacLure ,S Cunningham -  Robert Gordon University Aberdeen

Background

  • Mental health issues are a common feature of primary care consultations and around a third of GP consultations have a mental health element.

  • The Scottish Government’s 10 year Mental Health Strategy has ambitions to transform services so every GP practice has multi-disciplinary teams (MDTs) who can support and treat patients with mental health issues while ensuring good communication with community mental health teams (CMHT) and secondary care services.
  • Achieving Excellence in Pharmaceutical Care – A strategy for Scotland (2017) has a commitment to integrate pharmacists with advanced clinical skills in GP practices to improve pharmaceutical care and contribute to the MDT.

  • Despite these strategic plans, there is currently a lack of specialist mental health clinical pharmacist prescriber input to the care of patients with within general practice in NHS Highland.

  • A 12 month pilot, funded by the Scottish Government’s Primary Care Transformation Fund, was conducted within two GP Practices in NHS Highland.

Service Aim and Objective 

To improve the pharmaceutical care delivered to patients with depression and/or
anxiety in primary care by:

  • providing evidence based psychopharmacological interventions

  • evidence based prescribing in line with NHS Highland Formulary

  • MDT working within primary care, and liaison with CMHTs and secondary care
    reducing GP workload relating to the treatment of mental health disorders

Discussion and Conclusion

  • Even when considering the evaluation limitations, it is clear that this pilot study has been successful.

  • All four service objectives were met either fully or partially.

  • Responses to the patient survey were overwhelmingly positive.

  • Written comments from patients were highly appreciative of the pharmacists and the impact of the service on their mental health.

 

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