Pharmacists should review every patient after a depression diagnosis, says RPS

The Royal Pharmaceutical Society says that patients with a new diagnosis of depression, starting out on treatment, should have a structured review with a pharmacist.

Sandra Gidley, chair of the Royal Pharmaceutical Society English Pharmacy Board

Pharmacists in community settings should be enabled to holistically support people with mental health problems when starting out on their medicines, according to a new report published by the Royal Pharmaceutical Society (RPS).

The RPS report says that this could be achieved through the inclusion of antidepressants in a service like the New Medicine Service (NMS), to improve adherence and reduce hospital admissions.

It comes as the Pharmaceutical Services Negotiating Committee (PSNC) revealed that it will be lobbying for the NMS to include antidepressants as part of its discussions over the new community pharmacy contract.

The RPS recommendations come in the report “No health without mental health: how can pharmacy support people with mental health problems?”, which will be launched at the House of Commons on 6 June 2018, and forms part of the Society’s new mental health campaign.

The document reflects the findings of a roundtable hosted by the RPS on the 1 May 2018, which brought together patient groups, pharmacists, psychiatrists, GPs and health service and professional bodies to examine the potential role that pharmacy can play in supporting patients with mental health problems.

The report calls for pharmacists in England to play a greater role in supporting people with mental health problems and help eradicate inequalities in their care.

It also says that pharmacists should be given full access to the patient record and commissioned to complete physical health checks for people with mental health issues, which could also include giving lifestyle advice around exercise and smoking cessation. And that every NHS mental health team — whether based in the community or hospital — should have routine access to the expertise of a mental health pharmacist.

“It’s crucial that the government and the NHS make the most of the pharmacy workforce to better support patients and commission services which integrate pharmacists into care pathways that can better support patients,” said chair of the RPS English Pharmacy Board, Sandra Gidley. 

At the parliamentary launch, Gidley said that the treatment gap between mental and physical health was “enormous,” and the poorer health of people with mental health problems was “shaming”.

“In every setting, pharmacists can make a huge difference to the mental health of their patients and so help demonstrate in a practical way the parity of esteem there should be between mental and physical health problems,” she added.

Alastair Buxton, director of NHS services at the PSNC, told The Pharmaceutical Journal that an expansion of the NMS to include antidepressants is already part of its community pharmacy care framework proposals, which it is discussing with NHS England and the Department of Health and Social Care.

Buxton said: “We welcome this report and the recognition of community pharmacy’s potential to provide easily accessible support for people with mental health problems, such as by providing physical health checks.”

Chair of the Royal College of Psychiatrists psychopharmacology committee, David Baldwin, said pharmacists have a “pivotal” role in mental health care: “Psychiatrists recognise the important role of pharmacists in helping patients make the best use of their medicines, including their efforts to support patients when pharmacological treatment is not suitable or no longer needed.”

Ray Lyon, chief pharmacist at Sussex Partnership NHS foundation trust, endorsed the move to routinely involve mental health pharmacists in community and hospital mental health teams: “I would absolutely support the need for more specialist mental health pharmacists to be much more engaged with mental health services in the community.

“The majority of mental health patients are treated in the community, but the majority of mental health pharmacists are focused on inpatients.”

Mental health charity Mind’s chief executive, Paul Farmer, said that, first and foremost, pharmacists can help make sure that anyone prescribed medication for their mental health is given the full picture about their treatment, including side-effects, and can encourage people to visit their GP where necessary: “They are ideally placed to signpost people to other services and provide general health advice in an informal accessible setting,” he said.

“This report will be a valuable resource to kick-start conversation and — more importantly — action, looking at how we can ensure that pharmacists and primary care services as a whole are doing all they can to give people with mental health problems the support they deserve.”

An NHS spokesperson said that high street pharmacy services have an important role to play alongside GPs, “in ensuring people with mental ill health get treatment for mind and body, at a convenient location and when they need it”.

The RPS full mental health policy document is available to view on its website.

Last updated
The Pharmaceutical Journal, PJ, June 2018, Vol 300, No 7914;300(7914):DOI:10.1211/PJ.2018.20204962

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