Press release: Pharmacist ‘intelligent’ referrals to a Psychiatric Liaison Team

Pharmacy Research UK (PRUK) are delighted to announce the publication of research funded by the charity which explored the role pharmacists could play in enhancing mental health patients’ access to a psychiatric liaison team. The research was conducted by Dr Julie Brooks at Aston University and aimed to investigate whether a specialist pharmacist can use real-time dispensing information to identify, review and refer patients to a psychiatric liaison team.  The study also aimed to establish whether a new pharmacy referral system could facilitate a reduction in the time from admission to referral to the psychiatric liaison team, in addition to increasing the number of patients accessing the service; and to explore the process of referrals to a psychiatric liaison team in an acute NHS Hospital Trust.

Antipsychotic medications are associated with an increased risk of falls, delirium, cerebrovascular events and all can cause death. It is crucial that patients prescribed these agents receive regular specialist review to optimise therapy and prevent harm . This is achieved at City Hospital with the Rapid Assessment Interface and Discharge (RAID) team. Traditionally, patients were seen by RAID following a referral from medical or nursing staff, however when prescribing was analysed it was found that only a third of patients on these agents were referred. There was therefore the potential to establish if pharmacy could help improve patient’s access to RAID. This was an alternative to the traditional model of pharmacy, with the hope to target clinical services according to patient need rather than by physical ward location. A novel pharmacist referral system was developed using real-time dispensing information to identify hospital in-patients receiving antipsychotics, mood stabilisers or dementia medicines.

This study objectives were

• To determine if dispensing event data be used in real time to identify hospital in-patients receiving treatment for a mental illness and if this data could be used by a pharmacist to locate and subsequently review patients receiving treatment for a mental illness.
• To establish if pharmacists can refer patients to a liaison psychiatric team for inpatient review. What the pharmacotherapeutic outcomes of these referrals are and if a pharmacist referral pathway reduces the rate of referrals from other health care professionals.
• To evaluate what constitutes an appropriate referral. What information is required and which health care professionals are able to provide this information.

The key learnings from this study were:

1. The pharmacy referral service was found to enhance the clinical management of the vulnerable mental health patient in the hospital setting.
2. Although, the model was demonstrated in mental health, it is felt that it could have a wider use according to the prescription of any high-risk medication.
3. Access to, and transition of information between care sectors was found to be a significant problem and improvements are recommended.

For more information please contact PRUK at practice.research@rpharms.com

Notes to Editors

1. PRUK is the principle funder of pharmacy research in the UK. Founded as a result of a merger in 2012 of two previous research funding charities, PRUK has a broad programme of research in place. PRUK funds both research projects and individual bursaries to improve skills across the pharmacy sector. Registered charity number 1148335.
2. For the full research report see http://pharmacyresearchuk.org/wp-content/uploads/2016/05/Pharmacist-%E2%80%98intelligent%E2%80%99-referrals-to-a-Psychiatric-Liaison-Team.pdf