Exploring the implementation of a novel community pharmacist-led support service for people living with severe and persistent mental illness

Ricki Ng; Sarira El-Den; Jack C Collins; Victoria Stewart; Sara S McMillan; Jie Hu; Amanda J Wheeler; Claire L O'Reilly

doi:10.1016/j.sapharm.2024.02.017

Exploring the implementation of a novel community pharmacist-led support service for people living with severe and persistent mental illness

Res Social Adm Pharm. 2024 Mar 2:S1551-7411(24)00082-2. doi: 10.1016/j.sapharm.2024.02.017. Online ahead of print.

Authors

Ricki Ng¹, Sarira El-Den², Jack C Collins², Victoria Stewart³, Sara S McMillan³, Jie Hu⁴, Amanda J Wheeler⁵, Claire L O'Reilly²

Affiliations

¹ The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: ricki.ng@sydney.edu.au.
² The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia.
³ Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia.
⁴ Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
⁵ Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

PMID: 38467520
DOI: 10.1016/j.sapharm.2024.02.017

Abstract

Background: Community pharmacists are well-placed to promote and provide mental health medication management services. However, literature evaluating the impact of pharmacy services in supporting people living with severe and persistent mental illness (SPMI) is currently limited. An individualised, goal-oriented pharmacist-led support service that focused on improving the physical and mental health of consumers living with SPMI, namely the PharMIbridge intervention, was provided to consumer participants as part of the PharMIbridge Randomised Controlled Trial (RCT).

Objective(s): To explore the experiences of the participants who delivered and supported the implementation of the PharMIbridge intervention and propose ideas and supports needed for broader implementation and sustainability of pharmacist-led support services for people living with SPMI.

Methods: Interviews and focus group discussions were undertaken with PharMIbridge pharmacists and mentors, respectively. Audio-recordings were de-identified and transcribed verbatim. Data analysis was conducted using an iterative, inductive approach. The key themes identified were furthered divided into subthemes. Subthemes were then mapped to the EPIS (Exploration, Preparation, Implementation and Sustainment) framework.

Results: Data were collected from one focus group involving six RCT mentors and 16 semi-structured interviews with community pharmacists. Five overarching themes emerged: "Training needs", "Pharmacist integration within the healthcare system", "Environmental factors", "Attitudes and behaviour" and "Pharmacy operations". Twelve subthemes were mapped to EPIS phases "Preparation", "Implementation" and "Sustainment" and EPIS constructs "Outer" context, "Inner" context and "Bridging" factors.

Conclusion: Adequate remuneration and supports to encourage healthcare professional collaboration are necessary to establish and sustain functioning, integrated pharmacy mental health services. A shift in pharmacy business and workflow models is necessary to support community pharmacies to implement mental health services. In addition, there is a need to promote psychological support services to ensure that pharmacists are well supported while delivering pharmacy mental health services.

Keywords: Community pharmacy; Implementation science; Mental health; Pharmacist; Professional service; Severe and persistent mental illness.