The role of the clinical pharmacist in mental health hospital-in-the-home: A scoping review

Mechaiel Farag; Leanne Chalmers; Kreshnik Hoti; Jeff Hughes

doi:10.1016/j.sapharm.2022.04.004

The role of the clinical pharmacist in mental health hospital-in-the-home: A scoping review

Res Social Adm Pharm. 2022 Oct;18(10):3724-3735. doi: 10.1016/j.sapharm.2022.04.004. Epub 2022 Apr 20.

Authors

Mechaiel Farag¹, Leanne Chalmers², Kreshnik Hoti³, Jeff Hughes⁴

Affiliations

¹ Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia; North Metropolitan Health Service - Mental Health Pharmacy, Graylands Hospital, Brockway Road, Mount Claremont, Western Australia, 6010, Australia. Electronic address: Mechaiel.Farag@postgrad.curtin.edu.au.
² Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia. Electronic address: leanne.chalmers@curtin.edu.au.
³ Faculty of Medicine, Division of Pharmacy, University of Prishtina, Pristina, Republic of Kosovo. Electronic address: kreshnik.hoti@curtin.edu.au.
⁴ Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia. Electronic address: J.D.Hughes@curtin.edu.au.

PMID: 35490088
DOI: 10.1016/j.sapharm.2022.04.004

Abstract

Background: The concept of integrating a clinical pharmacist (CP) within a Hospital-in-the-Home (HiTH) program is relatively new. Little is known about the role of a pharmacist in HiTH programs focused on mental health (MH).

Objectives: To describe the role of a CP within an MH-HiTH program, focusing on the specific tasks performed by a pharmacist in this position, their benefits and limitations.

Methods: MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science and the grey literature were searched without any date limits for references in English that included 2 or more of the following key terms (or their synonyms): "HiTH", "clinical pharmacist" and "mental health". Two reviewers independently screened and analysed the data.

Results: Of 60,482 screened references, 6 included all 3 key terms: 2 were HiTH guideline documents, 2 were conference abstracts and 2 were journal articles. These papers discussed MH-HiTH programs or similar home-care services where a CP was incorporated in the treating team to address medication management and adherence during a home visit. There is evidence that MH-HiTH CPs identify and resolve medication-related problems (MRPs), as well as improve medication adherence, patient care, hospital admission rates and emergency department presentations. An additional 54 references including 2 key terms provided corroborating evidence of an MH-HiTH CP role focused on improving patient care via 4 key groups of tasks: clinical pharmacy, mental healthcare, home medicines review and facilitation of care transition through medication reconciliation and follow-up.

Conclusions: Although there is currently a paucity of literature describing the incorporation of a CP in an MH-HiTH program, preliminary evidence shows it can improve medication management. This has potential to improve patient outcomes as has been seen in similar home-based settings, but limitations such as time constraints are notable barriers. More robust studies are needed to evaluate these outcomes.

Keywords: Clinical pharmacist; HITH; Home health care; Hospital in the home; Mental health; Scoping review.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Hospitals, Psychiatric
Humans
Medication Reconciliation
Pharmacists*
Pharmacy Service, Hospital*
Systematic Reviews as Topic