Community pharmacist-led services to support people living with severe and persistent mental illness: An evaluation of pharmacists’ training and experiences during implementation

Abstract

Introduction Community pharmacists are well-placed to identify and monitor the health and wellbeing of people living with severe and persistent mental illness (SPMI). The PharMIbridge Randomised Controlled Trial (RCT) was developed to evaluate the effectiveness of an individualised, pharmacist-led intervention (PharMIbridge intervention), compared to standard care (MedsCheck). The aim of this thesis was to explore pharmacists’ training and experiences during implementation of community pharmacy services, delivered as part of the RCT, for people living with SPMI.

Methods A systematic review was conducted to explore the impact of pharmacist-led interventions for people living with SPMI. The PharMIbridge training program was evaluated using pre/post questionnaires and debrief sessions conducted after simulated patient role-plays were qualitatively analysed. Interviews were conducted with participating pharmacists to explore their experiences following implementation of the PharMIbridge intervention and MedsCheck service. Results

Findings of the systematic review highlighted the lack of evidence for community pharmacist-led interventions. Following PharMIbridge training, pharmacists had greater knowledge and confidence to support the physical healthcare needs of people living with SPMI but described difficulties initiating conversations about suicide. The lack of interdisciplinary collaboration was identified as hindering implementation. Factors that could support implementation included pharmacy remuneration and the need for adjustments to the pharmacy workflow.

Conclusions Training to ensure that pharmacists are capable of supporting people living with SPMI is essential. Psychological support services are needed to support pharmacists who deliver services to people living with SPMI. Further research is required to evaluate the strategies proposed for effective implementation of community pharmacy services.