Skip to main content
Top
Published in: International Journal of Clinical Pharmacy 5/2023

08-09-2023 | Care | Research Article

Between what is and what could be: a survey of pharmacists’ practices, attitudes, and beliefs in the provision of mental health care

Authors: Amy Soubolsky, Katelyn Halpape, Derek Jorgenson, Alfred J. Remillard, Candace Necyk

Published in: International Journal of Clinical Pharmacy | Issue 5/2023

Login to get access

Abstract

Background

Pharmacists can have an essential role in providing care for patients with mental illness. There are gaps in the understanding of the current extent of pharmacists’ involvement in caring for patients with mental illness and their readiness to effectively provide this care.

Aim

To describe the current practices, attitudes, and beliefs of pharmacists in providing care to individuals with mental illness, and to assess factors that may impact these practices.

Method

An electronic questionnaire was emailed to pharmacists in Saskatchewan, Canada. Likert scale questions were utilized, and data were analyzed using descriptive statistics and content analysis for free-text responses.

Results

The response rate was 9.1% (n = 146/1596). Fewer than 20% of respondents reported they were providing the clinical services listed to most or all patients with mental illness, except for providing basic medication education (61%). Almost all agreed it is a pharmacist’s role to provide all the services (61–98% for different services) and many were motivated to provide them (47–91%). The factors most frequently selected as having the greatest impact on service provision were insufficient knowledge (27%, n = 34) and competing priorities (19%, n = 24).

Conclusion

Consistent with international trends, Saskatchewan pharmacists reported low provision of clinical services for individuals with mental illness, despite a readiness to provide these services. There is an opportunity and a need to better utilize pharmacists internationally in the provision of mental health care.
Appendix
Available only for authorised users
Literature
6.
go back to reference Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications a systematic review and meta-analysis. JAMA Psychiatry. 2015;72(4):334–41.PubMedPubMedCentralCrossRef Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications a systematic review and meta-analysis. JAMA Psychiatry. 2015;72(4):334–41.PubMedPubMedCentralCrossRef
8.
go back to reference Kohn R, Saxena S, Levav I, et al. The treatment gap in mental health care. Bull World Health Organ. 2004;82(11):858–66.PubMedPubMedCentral Kohn R, Saxena S, Levav I, et al. The treatment gap in mental health care. Bull World Health Organ. 2004;82(11):858–66.PubMedPubMedCentral
11.
go back to reference Bell JS, Whitehead P, Aslani P, et al. Drug-related problems in the community setting: pharmacists’ findings and recommendations for people with mental illnesses. Clin Drug Investig. 2006;26(7):415–25.PubMedCrossRef Bell JS, Whitehead P, Aslani P, et al. Drug-related problems in the community setting: pharmacists’ findings and recommendations for people with mental illnesses. Clin Drug Investig. 2006;26(7):415–25.PubMedCrossRef
12.
go back to reference García S, Martínez-Cengotitabengoa M, López-Zurbano S, et al. Adherence to antipsychotic medication in bipolar disorder and schizophrenic patients. J Clin Psychopharmacol. 2016;36(4):355–71.PubMedPubMedCentralCrossRef García S, Martínez-Cengotitabengoa M, López-Zurbano S, et al. Adherence to antipsychotic medication in bipolar disorder and schizophrenic patients. J Clin Psychopharmacol. 2016;36(4):355–71.PubMedPubMedCentralCrossRef
13.
go back to reference Gallego JA, Bonetti J, Zhang J, et al. Prevalence and correlates of antipsychotic polypharmacy: a systematic review and meta-regression of global and regional trends from the 1970s to 2009. Schizophr Res. 2012;138(1):18–28.PubMedPubMedCentralCrossRef Gallego JA, Bonetti J, Zhang J, et al. Prevalence and correlates of antipsychotic polypharmacy: a systematic review and meta-regression of global and regional trends from the 1970s to 2009. Schizophr Res. 2012;138(1):18–28.PubMedPubMedCentralCrossRef
15.
go back to reference Meagher D, Moran M. Sub-optimal prescribing in an adult community mental health service: prevalence and determinants. Psychiatr Bull. 2003;27(7):266–70.CrossRef Meagher D, Moran M. Sub-optimal prescribing in an adult community mental health service: prevalence and determinants. Psychiatr Bull. 2003;27(7):266–70.CrossRef
19.
go back to reference Matlala M, Maponya ML, Chigome CK, et al. Overview of mental health: a public health priority. SA Pharm J. 2018;85(6):46–53. Matlala M, Maponya ML, Chigome CK, et al. Overview of mental health: a public health priority. SA Pharm J. 2018;85(6):46–53.
21.
25.
go back to reference Cipolle RJ, Strand LM, Morley PC. Chapter 1. Medication management services. In: Cipolle RJ, Strand LM, Morley PC, editors. Pharmaceutical care practice: the patient-centered approach to medication management services, 3rd ed. New York: The McGraw-Hill Companies; 2012. ISBN: 78-0-07-175638-9. Cipolle RJ, Strand LM, Morley PC. Chapter 1. Medication management services. In: Cipolle RJ, Strand LM, Morley PC, editors. Pharmaceutical care practice: the patient-centered approach to medication management services, 3rd ed. New York: The McGraw-Hill Companies; 2012. ISBN: 78-0-07-175638-9.
26.
go back to reference Tsuyuki RT, Beahm NP, Okada H, et al. Pharmacists as accessible primary health care providers: review of the evidence. Can Pharm J. 2018;151(1):4–5.CrossRef Tsuyuki RT, Beahm NP, Okada H, et al. Pharmacists as accessible primary health care providers: review of the evidence. Can Pharm J. 2018;151(1):4–5.CrossRef
29.
go back to reference Goldstone LW, Dipaula BA, Werremeyer A, et al. The role of board certified psychiatric pharmacists in expanding access to care and improving patient outcomes. Psychiatr Serv. 2021;72(7):794–801.PubMedCrossRef Goldstone LW, Dipaula BA, Werremeyer A, et al. The role of board certified psychiatric pharmacists in expanding access to care and improving patient outcomes. Psychiatr Serv. 2021;72(7):794–801.PubMedCrossRef
31.
go back to reference Finley PR, Crismon ML, Rush AJ. Evaluating the impact of pharmacists in mental health: a systematic review. Pharmacotherapy. 2003;23(12):1634–44.PubMedCrossRef Finley PR, Crismon ML, Rush AJ. Evaluating the impact of pharmacists in mental health: a systematic review. Pharmacotherapy. 2003;23(12):1634–44.PubMedCrossRef
34.
go back to reference Goldstone LW, DiPaula BA, Caballero J, et al. Improving medication-related outcomes for patients with psychiatric and neurologic disorders: value of psychiatric pharmacists as part of the health care team. Ment Health Clin. 2015;5(1):1–28.CrossRef Goldstone LW, DiPaula BA, Caballero J, et al. Improving medication-related outcomes for patients with psychiatric and neurologic disorders: value of psychiatric pharmacists as part of the health care team. Ment Health Clin. 2015;5(1):1–28.CrossRef
35.
go back to reference Kaboli PJ, Hoth AB, McClimon BJ, et al. Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006;166(9):955–64.PubMedCrossRef Kaboli PJ, Hoth AB, McClimon BJ, et al. Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006;166(9):955–64.PubMedCrossRef
37.
go back to reference Hattingh HL, Scahill S, Fowler JL, et al. Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature. J Ment Health. 2016;25(6):550–9.PubMedCrossRef Hattingh HL, Scahill S, Fowler JL, et al. Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature. J Ment Health. 2016;25(6):550–9.PubMedCrossRef
38.
go back to reference Rubio-Valera M, Chen TF, O’Reilly CL, et al. New roles for pharmacists in community mental health care: a narrative review. Int J Environ Res Public Health. 2014;11(10):10967–90.PubMedPubMedCentralCrossRef Rubio-Valera M, Chen TF, O’Reilly CL, et al. New roles for pharmacists in community mental health care: a narrative review. Int J Environ Res Public Health. 2014;11(10):10967–90.PubMedPubMedCentralCrossRef
40.
go back to reference Canales PL, Dorson PG, Crismon ML. Outcomes assessment of clinical pharmacy services in a psychiatric inpatient setting. Am J Health Syst Pharm. 2001;58(14):1309–16.PubMedCrossRef Canales PL, Dorson PG, Crismon ML. Outcomes assessment of clinical pharmacy services in a psychiatric inpatient setting. Am J Health Syst Pharm. 2001;58(14):1309–16.PubMedCrossRef
41.
go back to reference Finley PR, Rens HR, Pont JT, et al. Impact of a collaborative pharmacy practice model on the treatment of depression in primary care. Am J Health Syst Pharm. 2002;59(16):1518–26.PubMedCrossRef Finley PR, Rens HR, Pont JT, et al. Impact of a collaborative pharmacy practice model on the treatment of depression in primary care. Am J Health Syst Pharm. 2002;59(16):1518–26.PubMedCrossRef
42.
go back to reference Marques LA, Galduróz JC, Fernandes MR, et al. Assessment of the effectiveness of pharmacotherapy follow-up in patients treated for depression. J Manag Care Pharm. 2013;19(3):218–27.PubMed Marques LA, Galduróz JC, Fernandes MR, et al. Assessment of the effectiveness of pharmacotherapy follow-up in patients treated for depression. J Manag Care Pharm. 2013;19(3):218–27.PubMed
43.
go back to reference Caballero J, Souffrant G, Heffernan E. Development and outcomes of a psychiatric pharmacy clinic for indigent patients. Am J Health Syst Pharm. 2008;65(3):229–33.PubMedCrossRef Caballero J, Souffrant G, Heffernan E. Development and outcomes of a psychiatric pharmacy clinic for indigent patients. Am J Health Syst Pharm. 2008;65(3):229–33.PubMedCrossRef
44.
go back to reference Finley PR, Bluml BM, Bunting BA, et al. Clinical and economic outcomes of a pilot project examining pharmacist-focused collaborative care treatment for depression. J Am Pharm Assoc. 2011;51(1):40–9.CrossRef Finley PR, Bluml BM, Bunting BA, et al. Clinical and economic outcomes of a pilot project examining pharmacist-focused collaborative care treatment for depression. J Am Pharm Assoc. 2011;51(1):40–9.CrossRef
45.
go back to reference Herbert C, Winkler H. Impact of a clinical pharmacist-managed clinic in primary care mental health integration at a Veterans Affairs health system. Ment Health Clin. 2018;8(3):105–9.PubMedPubMedCentralCrossRef Herbert C, Winkler H. Impact of a clinical pharmacist-managed clinic in primary care mental health integration at a Veterans Affairs health system. Ment Health Clin. 2018;8(3):105–9.PubMedPubMedCentralCrossRef
48.
go back to reference Giannetti V, Caley CF, Kamal KM, et al. Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs. Int J Clin Pharm. 2018;40(5):1096–105.PubMedCrossRef Giannetti V, Caley CF, Kamal KM, et al. Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs. Int J Clin Pharm. 2018;40(5):1096–105.PubMedCrossRef
49.
go back to reference Cates ME, Burton AR, Woolley TW. Attitudes of pharmacists toward mental illness and providing pharmaceutical care to the mentally ill. Ann Pharmacother. 2005;39(9):1450–5.PubMedCrossRef Cates ME, Burton AR, Woolley TW. Attitudes of pharmacists toward mental illness and providing pharmaceutical care to the mentally ill. Ann Pharmacother. 2005;39(9):1450–5.PubMedCrossRef
50.
go back to reference Scheerder G, De Coster I, Van Audenhove C. Pharmacists’ role in depression care: A survey of attitudes, current practices, and barriers. Psychiatr Serv. 2008;59(10):1155–60.PubMedCrossRef Scheerder G, De Coster I, Van Audenhove C. Pharmacists’ role in depression care: A survey of attitudes, current practices, and barriers. Psychiatr Serv. 2008;59(10):1155–60.PubMedCrossRef
51.
go back to reference Haslam L, Gardner DM, Murphy AL. A retrospective analysis of patient care activities in a community pharmacy mental illness and addictions program. Res Social Adm Pharm. 2020;16(4):522–8.PubMedCrossRef Haslam L, Gardner DM, Murphy AL. A retrospective analysis of patient care activities in a community pharmacy mental illness and addictions program. Res Social Adm Pharm. 2020;16(4):522–8.PubMedCrossRef
53.
go back to reference Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice: the patient-centered approach to medication management services. 3rd ed. New York: The McGraw-Hill Companies; 2012. ISBN: 78-0-07-175638-9. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice: the patient-centered approach to medication management services. 3rd ed. New York: The McGraw-Hill Companies; 2012. ISBN: 78-0-07-175638-9.
55.
go back to reference American Psychiatric Association. Substance-Related and Addictive Disorders. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association; 2013. ISBN: 978-0890425558. American Psychiatric Association. Substance-Related and Addictive Disorders. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association; 2013. ISBN: 978-0890425558.
56.
go back to reference Stemler S. An overview of content analysis. Pract Assess Res Eval. 2000;7(1):17. Stemler S. An overview of content analysis. Pract Assess Res Eval. 2000;7(1):17.
57.
go back to reference Moser A, Korstjens I. Series: practical guidance to qualitative research. Part 3: sampling, data collection and analysis. Eur J Gen Pract. 2018;24(1):9–18.PubMedCrossRef Moser A, Korstjens I. Series: practical guidance to qualitative research. Part 3: sampling, data collection and analysis. Eur J Gen Pract. 2018;24(1):9–18.PubMedCrossRef
58.
59.
go back to reference Isenor JE, Cossette B, Murphy AL, et al. Community pharmacists’ expanding roles in supporting patients before and during COVID-19: An exploratory qualitative study. Int J Clin Pharm. 2023;45(1):64–78.PubMedCrossRef Isenor JE, Cossette B, Murphy AL, et al. Community pharmacists’ expanding roles in supporting patients before and during COVID-19: An exploratory qualitative study. Int J Clin Pharm. 2023;45(1):64–78.PubMedCrossRef
60.
go back to reference Goodman CS, Smith TJ, LaMotte JM. A survey of pharmacists’ perceptions of the adequacy of their training for addressing mental health–related medication issues. Ment Health Clin. 2018;7(2):69–73.PubMedPubMedCentralCrossRef Goodman CS, Smith TJ, LaMotte JM. A survey of pharmacists’ perceptions of the adequacy of their training for addressing mental health–related medication issues. Ment Health Clin. 2018;7(2):69–73.PubMedPubMedCentralCrossRef
61.
go back to reference Murphy AL, Gardner DM, Jacobs LM. Patient care activities by community pharmacists in a capitation funding model mental health and addictions program. BMC Psychiatry. 2018;18(1):192.PubMedPubMedCentralCrossRef Murphy AL, Gardner DM, Jacobs LM. Patient care activities by community pharmacists in a capitation funding model mental health and addictions program. BMC Psychiatry. 2018;18(1):192.PubMedPubMedCentralCrossRef
62.
go back to reference Murphy AL, Martin-Misener R, Kutcher SP, et al. From personal crisis care to convenience shopping: an interpretive description of the experiences of people with mental illness and addictions in community pharmacies. BMC Health Serv Res. 2016;16(1):569.PubMedPubMedCentralCrossRef Murphy AL, Martin-Misener R, Kutcher SP, et al. From personal crisis care to convenience shopping: an interpretive description of the experiences of people with mental illness and addictions in community pharmacies. BMC Health Serv Res. 2016;16(1):569.PubMedPubMedCentralCrossRef
64.
go back to reference Bell Lynum KS, Hill AM. Psychiatric services: a platform for MTM. J Pharm Pract. 2015;28(1):13–20.CrossRef Bell Lynum KS, Hill AM. Psychiatric services: a platform for MTM. J Pharm Pract. 2015;28(1):13–20.CrossRef
65.
go back to reference Eaves S, Gonzalvo J, Hamm JA, et al. The evolving role of the pharmacist for individuals with serious mental illness. J Am Pharm Assoc. 2020;60(5S):S11–4.CrossRef Eaves S, Gonzalvo J, Hamm JA, et al. The evolving role of the pharmacist for individuals with serious mental illness. J Am Pharm Assoc. 2020;60(5S):S11–4.CrossRef
66.
go back to reference Moore T, Groppi J, Ourth H, et al. Increasing access to care using clinical pharmacy specialist providers in outpatient mental health: Successful practice integration within the Department of Veterans Affairs. J Am Pharm Assoc. 2020;60(5S):S107–12.CrossRef Moore T, Groppi J, Ourth H, et al. Increasing access to care using clinical pharmacy specialist providers in outpatient mental health: Successful practice integration within the Department of Veterans Affairs. J Am Pharm Assoc. 2020;60(5S):S107–12.CrossRef
67.
go back to reference Gable KN, Stunson MJ. Clinical pharmacist interventions on an assertive community treatment team. Community Ment Health J. 2010;46(4):351–5.PubMedCrossRef Gable KN, Stunson MJ. Clinical pharmacist interventions on an assertive community treatment team. Community Ment Health J. 2010;46(4):351–5.PubMedCrossRef
68.
go back to reference McMillan SS, Kelly F, Hattingh HL, et al. The impact of a person-centred community pharmacy mental health medication support service on consumer outcomes. J Ment Health. 2018;27(2):164–73.PubMedCrossRef McMillan SS, Kelly F, Hattingh HL, et al. The impact of a person-centred community pharmacy mental health medication support service on consumer outcomes. J Ment Health. 2018;27(2):164–73.PubMedCrossRef
69.
go back to reference Knox K, Hattingh L, Wheeler AJ. Community pharmacy staff motivations and barriers to working with mental health consumers. J Pharm Pract Res. 2016;46(3):245–52.CrossRef Knox K, Hattingh L, Wheeler AJ. Community pharmacy staff motivations and barriers to working with mental health consumers. J Pharm Pract Res. 2016;46(3):245–52.CrossRef
70.
go back to reference Phokeo V, Sproule B, Raman-Wilms L. Community pharmacists’ attitudes toward and professional interactions with users of psychiatric medication. Psychiatr Serv. 2004;55(12):1434–6.PubMedCrossRef Phokeo V, Sproule B, Raman-Wilms L. Community pharmacists’ attitudes toward and professional interactions with users of psychiatric medication. Psychiatr Serv. 2004;55(12):1434–6.PubMedCrossRef
71.
go back to reference Rickles NM, Dube GL, Mccarter A, et al. Relationship between attitudes toward mental illness and provision of pharmacy services. J Am Pharm Assoc. 2010;50(6):704–13.CrossRef Rickles NM, Dube GL, Mccarter A, et al. Relationship between attitudes toward mental illness and provision of pharmacy services. J Am Pharm Assoc. 2010;50(6):704–13.CrossRef
72.
go back to reference Silvia RJ, Lee KC, Bostwick JR, et al. Assessment of the current practice of psychiatric pharmacists in the United States. Ment Health Clin. 2020;10(6):346–53.PubMedPubMedCentralCrossRef Silvia RJ, Lee KC, Bostwick JR, et al. Assessment of the current practice of psychiatric pharmacists in the United States. Ment Health Clin. 2020;10(6):346–53.PubMedPubMedCentralCrossRef
Metadata
Title
Between what is and what could be: a survey of pharmacists’ practices, attitudes, and beliefs in the provision of mental health care
Authors
Amy Soubolsky
Katelyn Halpape
Derek Jorgenson
Alfred J. Remillard
Candace Necyk
Publication date
08-09-2023
Publisher
Springer International Publishing
Keyword
Care
Published in
International Journal of Clinical Pharmacy / Issue 5/2023
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-023-01633-6

Other articles of this Issue 5/2023

International Journal of Clinical Pharmacy 5/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.