A Systematic Review on the Impact of Clinical Pharmacist Interventions in Patients with Mental Health DisordersAuthor(s): Shareef Javedh, Rao Padma GM, Sridhar BS, Shariff A and Al-Bonni IMA
Introduction: Mental disorders are one of the most significant public health challenges and major cause of disability and overall global burden of diseases. They often receive multiple medications associated with their comorbid conditions and mental illness increasing the risk for drug related problems leading to increased risk of hospitalization, morbidity, mortality and healthcare expenditure. Aims/Objectives: The aim of this systematic review is to evaluate the impact of clinical pharmacist involvement in psychiatric settings in patients with mental disorders. Methodology: A literature search was undertaken using three electronic databases (PubMed, Scopus and Google Scholar) with full text by using the following search terms; ‘clinical pharmacist’ or ‘mental health pharmacist’, in combination with ‘psychiatry’, ‘psychiatric’ or ‘mental illness’ and ‘drug related problems’ or ‘interventions’. Studies published between January 2010 to December 2019 and references identified within the studies were included. Case studies and series were excluded. Results: Fifteen studies met the inclusion criteria, out of which forteen studies were carried out in inpatient health care settings and one within an outpatient assertive community treatment (ACT) team. Of the total studies, nine studies were prospective while six were retrospective study design in nature. Only six studies utilized control or comparison groups with three comprised of randomized and one non-randomized, one pre-post study design and one ‘before-and-after’ study intervention measures corresponding to evidence level of II, III-2 and III-3 respectively. The outcome evaluation measures showed that four studies reported clinical outcome, three were economic outcomes and two studies reported both clinical and humanistic outcome. The remaining six studies focused on impact evaluation measures. Conclusion: Multiple studies highlighted the positive impact of various services provided by the clinical pharmacist in psychiatric settings with respect to different outcome measures. However, the quality and measured outcomes of most of these studies vary greatly suggesting a need for additional well – designed randomized controlled trials assessing the various outcomes in patients with psychiatric disorders.