Academic Detailing engages members of the healthcare team and veterans in improving care for mental health conditions
In 2008, the Veterans Health Administration (VHA) chartered the VHA Academic Detailing Service through the Office of Mental Health and Pharmacy Benefits Management Services. A team of clinical pharmacists trained as academic detailers deliver targeted information through the use of key messages to providers during individual or group educational outreach visits. The objective of academic detailing is to influence prescribing behaviors to provide safe and cost-effective treatment modalities. Messages over the last year have focused on the appropriate use of antipsychotic medications and medication safety.
Implementation of an Algorithm for Depression Based on the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Trial in a Ambulatory Safety-Net Clinic
Major Depressive Disorder (MDD) is a disabling psychiatric illness and is defined by the occurrence of at least a single major depressive episode. The Sequenced Alternatives to Relieve Depression (STAR*D) trial was a multi-center, prospective, randomized control trial with broad inclusion criteria that intended to evaluate the most specific, cost-effective, and practical next step treatment options for treatment-resistant depression. STAR*D provided recommendations on how to start and modify therapy for MDD.
Despite guideline recommendations for alternative agents, benzodiazepines are still widely prescribed for anxiety and related disorders. Patient specific factors including older age, concomitant disease states, and concurrent medications can lead to increased risk for adverse events such as central nervous system depression and subsequent injury including falls.
investigation of the prevalence of anxiety and depression in patients with cystic fibrosis at Keck Hospital of University of Southern California
The rate of survival in cystic fibrosis (CF) has increase, but it is still complicated by high rates of morbidity, which may be compounded by anxiety and depression. Conflicting data about the prevalence of anxiety and depression in CF exists. Although data are conflicting, experts recommend screening for anxiety and depression at least annually. This study aims to contribute to available data, but more importantly to characterize the CF population at Keck Hospital of USC and work toward the implementing routine screening into standard practice.
Tallahassee Memorial Healthcare NeuroScience Center is a multidisciplinary clinical initiative that provides services to patients with neurological disorders. The NeuroScience Center houses a Memory Disorder Clinic, Parkinson 's Center, and Multiple Sclerosis Clinic. It also provides supportive services for patients with seizures, traumatic brain injury, and other neurological disorders. Pharmacists work with neurologists, social workers, neuropsychologists, speech therapists, and nurses to individually and collectively assess patients with these disorders. Practice faculty from Florida A&M University College of Pharmacy provide comprehensive medication reviews and other services such as patient and caregiver education.
The prevalence of metabolic syndrome (MS) in patients with schizophrenia or bipolar disorder may be twice that of the general population and treatment with atypical antipsychotics increases the risk of MS. Literature suggests patients with schizophrenia are less likely to receive management of concomitant medical conditions. The purpose of this study is to determine if patients with mental illness are less likely to receive interventions for uncontrolled cardiovascular risk factors.
Evaluation of clinical outcomes in patients who continued clozapine therapy despite moderate to severe leukopenia or neutropenia
The rare, but potentially fatal, side effect of agranulocytosis has caused the use of clozapine to be regulated more than any other antipsychotic medication. All patients must be registered in the Clozapine National Registry and frequent monitoring of WBC (white blood cell) count and ANC (absolute neutrophil count) must be performed every 7-28 days depending on the current duration of treatment. According to the clozapine monitoring guidelines provided by the Clozapine National Registry, a WBC count less than 3000/mm³ or ANC less than 1500/mm³ requires interruption of clozapine therapy. However, some physicians and patients are reluctant to discontinue clozapine. There are limited published reports in which clozapine was continued and the neutropenia was managed by adding lithium or granulopoiesis stimulating factors (GSFs), changing concomitant medications that might also be implicated in neutropenia, or observing to see if neutropenia is transient.