Retrospective evaluation of an inpatient psychiatric pharmacist consultation service.

OBJECTIVE

To describe and evaluate clinical outcomes of pharmacist consult service recommendations in an inpatient psychiatric setting.

DESIGN

Retrospective study.

SETTING

Austin, TX, between September 1, 2005, and May 31, 2006.

PATIENTS

105 patients receiving a pharmacy consult while admitted to the Austin State Hospital.

INTERVENTION

Completion of consultation pursuant to provider referral.

MAIN OUTCOME MEASURES

Clinical Global Impression (CGI)-Severity (CGI-S) and CGI-Improvement (CGI-I) scores were retrospectively determined by blinded psychiatric pharmacy specialists upon review of physician progress notes.

RESULTS

A total of 105 pharmacy consultations and associated physician progress notes were reviewed. Overall, 73% of the primary consultation recommendations were implemented. The most common reasons for referral to the psychopharmacology service were nonresponse to treatment and aggression. Patients with high implementation of consultation recommendations displayed more favorable endpoint CGI-S scores and displayed a greater CGI-I response rate compared with patients with low implementation of consult recommendations.

CONCLUSION

Implementing clinical pharmacists' consult recommendations was associated with significantly greater improvement in overall severity of illness and global improvement. This study supports the positive role that pharmacists have in optimizing patient care and clinical outcomes.