Psychiatric Pharmacy in a University Student Health System

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Psychiatric Pharmacy in a University Student
Health System

• Charles F. Caley, Pharm.D., BCPP
• Associate Clinical Professor
• University of Connecticut

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INTRODUCTION
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Mental Illness on Campus

• American College Health Survey
• Top 10 health problems during academic year
• Depression 17.8
• Anxiety 12.4
• SAD 8.1
• Top 10 health impediments to academic performance
• Depr/SAD/Anx 15.7

N 94,806 completed surveys
J Am College Health 200755(4)195206.
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College Student Mental Hlth SurveyPsychiatric
Diagnosis by Student Self-Report
N 939 UMich students completed surveys
NASPA Journal 200643(3)41031.
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DESCRIPTION OF SERVICE
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20,000 students at the University of
Connecticut Approximately 6,000 visits to CMHS
annually Two 0.5 FTE psychiatrists, one APRN,
seven therapists
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Psychiatric Pharmacist Services

• Consultation w/ patient record review / pt
  interview / written note in chart
• Consultation w/ record review and discussion with
  APRN
• Education
• Direct to patient
• Weekly APRN meetings
• Staff inservices
• Drug information questions

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Project Chronology
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IMPACT ON PATIENT CARE
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Results

• 27 patients consulted on to date
• 1842 yrs ( mean 24)
• Predominantly female
• Presenting w/ depression /or anxiety spectrum
• Typically not responding or not tolerating
  current tx
• Most receive full consult
• Recommendations implemented in 88 of cases

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Results

• Consultations by type of recommendation
• Change dose 8 (30)
• Change medication 7 (26)
• Start new medication 6 (22)
• Patient education 6 (22)
• No changes to tx plan 2 (7)
• Recommend adj. psychotherapy 1 (4)

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Staff Education

• Weekly APRN Meetings
• Clinical pharmacology
• Pk drugdrug interactions
• Psychotropic adverse effect profiles
• Pharmacotherapeutic selection process
• SHS Inservices
• Mechanisms of drug intolerance
• Drug interactions btwn common Rxs and common OTCs
• Serotonin syndrome review and update

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Results

• Clinical credibility firmly established
• Patients willing to
• Accept / implement tx recommendations
• Be taught about their meds and illnesses
• Patients gave positve feedback to APRNs
• APRNS, psychiatrists, therapists, CMHS director,
  SHS director
• High rate of implementing recommendations
• Clinical outcomes beyond implementation

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Future

• To maintain service funding
• Explore additional avenues for billing / funding
• Obtain outcome data
• Symptom severity change
• CMHS service use
• Academic performance
• Patient satisfaction
• Campus outreach
• Present project results at annual ACHA in June

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