The Pharmaceutical Journal
Vol 279 No 7459 p12
7 July 2007

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More medicines support for mental health patients in the community

A medicines clinic as part of a community mental health service

Pharmaceutical Care Awards

The Pharmaceutical Care Awards 2006 were presented at a celebratory dinner on 29 June 2007 at Apothecaries’ Hall, London. The dinner followed a conference at the Royal Pharmaceutical Society’s headquarters, where the finalists presented their projects to an audience of invited guests. The awards, organised by The Pharmaceutical Journal, are sponsored by GlaxoSmithKline and the Company Chemists’ Association

The recognition of limited specialist pharmacy support for patients with mental illness in Paddington, London, and the subsequent establishment of a clinic to fill this gap, was deemed to merit a Pharmaceutical Care Award.

Six months of research, including consultation between the pharmacy team at Central and North West London Mental Health Trust and the community mental health team (CMHT) raised issues, including:

• Service users believed that they were given insufficient information about their medicines and want to be more involved in the decision-making process around their medicines

• A large proportion of service users live in the community but pharmacy services are limited to inpatient settings

• Service users are more often in better mental health outside hospitals and require information during these periods to facilitate decision-making, concordance and, ultimately, maintenance of good mental health

To tackle these issues, the medicines clinic was set up. Louis Ovonlen, a pharmacist specialist in mental health, works with the CMHT, running two clinic sessions each week. Patients can be referred either by any member of the CMHT or they can self-refer. Mr Ovonlen provides advice and counselling, medication reviews, side effect monitoring and medicines education.

During each session issues related to better medicines use, such as drug choice, dose and side effects, are explored and proactive steps are developed to address any problems. Following each session, decisions are fed back to the CMHT for discussion. The clinic is a new approach to delivering expert pharmacy services, which are more traditionally delivered in hospitals to users in their most distressed states.

In some cases, the clinic has enabled seamless care because Mr Ovonlen works in both in- and outpatient settings and can establish a rapport with service users. Of the 21 clients seen, only four have been readmitted because of medication-related issues compared with 12 readmissions in the year before the clinic was established. Introducing a specialist pharmacist to the CMHT has facilitated better medicines management.