Telepharmacy at Mental Health Services: A new approach to medication therapy management during COVID-19

ABSTRACT

Service or Program The number of COVID-19 infections have increased dramatically since March 2020 in Qatar. Measures have been taken to minimize the risk of exposure to COVID-19 including medication home delivery by postal service and by using telemedicine at The Mental Health Service (MHS), a tertiary care hospital in Qatar. In order to continue patients' access to care during the pandemic, the Medication Therapy Management (MTM) clinic at MHS would like to utilize clinical pharmacists to offer patient counseling, medication reviews, and develop medication action plans with the patients via telepharmacy. Justification/Documentation Patients for whom counseling is essential to ensure positive outcomes of therapy were identified;patients on lithium or clozapine (phase 1), patient on newly prescribed psychotropics or on antipsychotic polypharmacy (phase 2), females on valproate in childbearing age (phase 3). The aim of this quality improvement (QI) project was to improve the number of patients currently receiving MTM service from baseline (90) by 20% by September 2020, 50% by December 2020 and 80% by March 2021. Outcome measure included percentage increase in patients from baseline who are receiving telepharmacy service, process measures included the percentage compliance of filling the Moresky Medication Adherence Scale-4 by the pharmacist, the percentage of referrals to other MHS services, balance measures were patient/caregivers and staff satisfaction. The improvement in outcome measure was successfully achieved in each phase;phase 1 - 28%, phase 2 - 82%, phase 3 - 127%. QI tools were used as appropriate. Adaptability This service was intended to be provided by clinical pharmacists to adult patients registered under MHS. Similar service can easily be adapted to another setting by clinical pharmacists using comparable strategies and measures. Significance: The lessons learnt from this QI project will help in increasing patients' access to care, promote better utilization of resources, and allow better communication and management of patients.