Comparison of pharmacist and physician prescribing for psychiatric inpatients

Drug prescribing for inpatients by three certified pharmacist prescribers and two psychiatrists at a 40-bed mental health facility in California was evaluated. The pharmacist prescribers were assigned diagnosed patients whose treatment plan was primarily pharmacologic. For each prescriber, 60 prescriptions were randomly selected to include 20 neuroleptic drugs, 20 anticholinergic drugs used to alleviate the parkinsonism-like syndrome induced by neuroleptic drugs, and 20 antidepressants. A panel of four clinical judges independently evaluated the appropriateness of each prescription using explicit screening criteria; the judges' mean scores were reported. The patients treated by pharmacists and physicians were similar in age, sex ratio, number of drugs prescribed, and number of medical diagnoses. There was no significant difference in the appropriateness of prescribing between pharmacists and physicians for anticholinergic drugs, while mean scores for pharmacists were significantly better than physicians for neuroleptic and antidepressant drugs. The mean scores for all prescribers in most areas were in the appropriate range. While the results are not applicable to all pharmacists, the certified pharmacist prescribers in this study prescribed drugs for psychiatric inpatients as safely and appropriately as the physicians.