Community pharmacists' attitudes toward providing care and services to patients with severe and persistent mental illness

Objectives: To assess community pharmacists' attitudes toward working with patients who have severe and persistent mental illness (SPMI) and to identify perceived barriers to providing care and services to this population.

Design: This study was a cross-sectional survey of community pharmacists in North Carolina. The questionnaire, which was distributed electronically, included demographic questions about the responder and pharmacy in which they practiced, Likert-type scale questions assessing pharmacists' comfort and attitudes towards working with patients with SPMI, and barriers preventing provision of care. The survey remained open for 30 days after distribution. Descriptive and inferential statistics were used to analyze survey results.

Setting and participants: All community pharmacists actively licensed in North Carolina.

Main outcome measures: Pharmacists' perceptions toward working with and delivering care to patients with SPMI.

Results: Of the 5582 pharmacists who received the survey, 458 completed it. Most respondents had been practicing 0-5 years (22%) or more than 20 years (51%) and the majority estimated that 0%- 25% of their patient population had SPMI. Ninety-one percent agreed that SPMI were real diseases, 81.6% agreed that patients with SPMI often misunderstand information about their medications, and 53.5% disagreed that patients with SPMI can independently manage their medications. Pharmacists responded that they felt confident monitoring efficacy and recognizing adverse effects of medications used to treat SPMI only 28.1% and 48.3% of the time, respectively. The key barriers identified in preventing community pharmacists from providing optimal care and services to this population are lack of time and lack of confidence in managing and monitoring medications used to treat SPMI.

Conclusion: Although pharmacists had a positive attitude toward working with this population, multiple barriers were identified that prevented optimal care. Identifying solutions to overcome these barriers could help to improve the overall care and increase the likelihood of success in treating patients with SPMI.