Enhancing Quality in Psychiatry with Psychiatrists (EQUIPP)--results from a pilot study

To pilot a pharmacist-led, patient centered medication management program.

Prospective, single arm trial.

Academic geriatric psychiatry outpatient clinic.

Outpatients at least 65 years old, proxy available if demented, and on two or more psychiatric medications.

A clinical pharmacist completed a baseline medication review and made evidence-based recommendations that were implemented by the pharmacist after discussion with the physician. The pharmacist made a minimum of monthly contact for 6 months to review medications and related issues.

The primary outcome was the change in number of medication related problems over time (3 and 6 months) as defined by a predetermined classification system.

The mean age of the 27 patients was 75 years, 10 of whom required a proxy to participate. On average, patients had nine chronic conditions and were taking 14 medications. The mean number (SD; range) of medication related problems at baseline was 4.1 (2.2; 0-8) and at 3 and 6 months were 3.6 (2.4, 0-9) and 3.4 (2.1; 0-8), respectively. Most follow-up problems were new (80% and 89% at 3 and 6 months, respectively).

Using a pharmacist to deliver a medication management program was feasible and addressed existing problems. New problems, however, developed over a short interval (3-6 months), suggesting that ongoing intervention is required.