Pharmacists improve quality of care for patients at ADHD clinic

When Raisa El-Kurdi, PharmD, CPP, started as a PGY1 community-based pharmacy resident at the Counseling and Psychological Services clinic University of North Carolina (UNC) Chapel Hill, she would accompany psychiatrist during patient visit. But these collaborative visits quickly evolved into El-Kurdi conducting her own appointments specifically with patients who have ADHD. According to study published in January 25, 2021, issue Journal American Pharmacists Association (JAPhA) about this one-of-a-kind practice model, integrating pharmacist for ADHD not only increased number but also improved quality care received how they were monitored adverse effects from medications. Patients take stimulant treat their need blood pressure heart rate checked regularly. Although stimulants are generally safe effective, known effects. JAPhA findings, pharmacist-run UNC’s yielded better adherence among monitoring (11% vs. 77%) (6% 75%) compared psychiatrist-run appointments. The by 1,003% (from 26 287) 3-year period on team. A single was able more than double total completed, allowing frequent follow-up ability manage complex cases. Researchers found that policy requiring signature medication contract when pharmacists involved (64% 75%). At clinic, assessing substance use mood initial is part prescribing Research has shown often present additional psychiatric conditions such anxiety or other disorders. During time collaboration started, two new completed alone. Substance documented therefore counted assessed, assessed both 53% 95% appointments, according results. “This will never because see benefit now,” said Macary Weck Marciniak, lead author associate professor UNC Eshelman School Pharmacy. benefits team made obvious data. From July 1, 2016, through June 30, 2019, data extracted clinic’s electronic health record 18 years older diagnosis visit evaluation follow-up. Data prior integration (July 2016–June 2017) after 2017– 2019). “[As pharmacists], we trained check [prescription drug program] every visit, being documented,” now full-time clinical clinic. “Getting template together really helped.” became first practitioner employed Campus Health Services. In addition, residents provide All been virtual since COVID-19 pandemic began last spring. Even things back normal campus, envisions hybrid model enjoyed convenience requesting now, road point necessarily easy. buy-in integrated outpatient mental definitely harder sell due providers thinking bread butter pharmacy, hypertension diabetes management,” El-Kurdi. “We did it, though,” said. “It goes show can be anything. As uniquely placed help educate counsel what expect, hopefully prevent early discontinuation medication. We develop same relationship our patients, communication key component feeling supported.”