Outcomes assessment of clinical pharmacy services in a psychiatric inpatient setting

The effects of psychiatric pharmacy services on clinical outcomes of acute care psychiatric inpatients were studied. Patients recruited at a state psy chiatric facility during phase 1 (October 1996-March 1997) served as the co ntrol group and received only traditional centralized pharmaceutical servic es and physician-requested psychiatric pharmacotherapy consultations. Patients recruited during phase 2 (May-December 1997) received intensive ps ychiatric pharmacy services and served as the experimental group. Pharmaceu tical services during phase 2 included attending treatment team meetings, p erforming baseline assessments and weekly reviews, providing pharmacotherap y recommendations, obtaining medication histories, reviewing drug administr ation records daily, monitoring for adverse drug reactions, conducting medi cation education classes, and counseling patients before discharge. Outcome Variables included clinical response determined with objective rating scal es, cost of care, length of stay, adverse events, rate of acceptance of rec ommendations, patient compliance with the first clinic visit scheduled afte r discharge, quality of life, and patient satisfaction. Data were analyzed for 48 patients in the control group and 45 patients in the experimental group. There were no significant differences between the t wo groups with respect to age, sex, duration of illness, number of hospital izations, and number of months since the last hospitalization. Patients in the experimental group showed significant improvements in clinical response acid drug-induced extrapyramidal symptoms compared with the controls and w ere highly satisfied with the pharmaceutical services they received. Medica tion costs did not differ significantly, and length of stay was about 29 da ys for each group. The provision of clinical pharmacy services provided to inpatients in an ac ute care psychiatric facility was associated with improvements in rating-sc ale scores for clinical response and for drug-induced extrapyramidal sympto ms.