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Patient perspective of a pilot pharmacist-led medicines and health education programme for mental health

Psychoeducation is the education of a person with a psychiatric disorder regarding the symptoms, treatments and prognosis of their illness[1]. There is evidence to suggest that it can improve outcomes for patients with mental health conditions[2]. A Cochrane review on psychoeducation for schizophrenia illustrated that it may improve a range of indicators, including relapse rates and readmissions, encourage medication concordance and reduce hospital stays.

A ten-week pilot programme to assess whether pharmacists could effectively deliver psychoeducation, in the form of a medicines and health education programme, was developed and delivered at Woodlands House (Whiteleaf Centre, Oxford Health NHS Foundation Trust), a mental health facility providing inpatient and community care.

The pilot included ten one-hour classes delivered to service users over ten consecutive weeks from October to December 2015. Each session included a PowerPoint presentation of health topics, with interactive activities and video links to aid learning. The following classes were delivered:

  • Introduction to schizophrenia;
  • Medicines to treat schizophrenia;
  • Management of antipsychotic side effects and monitoring;
  • Smoking and effects on health;
  • Depression;
  • Medicines to treat depression, side effects and monitoring;
  • Anxiety disorders;
  • Medicines to treat anxiety disorders;
  • Bipolar disorder;
  • Mood-stabilising medication.

The course aimed to educate service users on mental health conditions, medicines used to treat the conditions, management of side effects and health-monitoring requirements. Each session was designed to be interactive, and participants were encouraged to ask questions and share experiences of their mental health conditions.

Service users were given the opportunity to enrol for the education programme; this was facilitated by the occupational therapist ward-activity programme. Seven service users who had expressed interest were available to attend the classes. Eight classes were delivered by a pharmacist and preregistration pharmacists, and two classes were delivered by a staff grade doctor. The pharmacist-led sessions included an introduction of topics and establishing rules; a PowerPoint presentation; playing an interactive game or watching a video to reinforce knowledge; and a question-and-answer session.

On completion of the programme, participants were asked to take part in a survey to find out what they thought about the education programme. The survey (Box 1) asked participants about their knowledge of mental health conditions and medicines, communication with health professionals, and their perceived future health choices.

Box 1: Service user questionnaire

  1. Do you feel that your knowledge of mental health conditions has improved by your attending medicines education classes?
  2. Do you feel that your knowledge of mental health medicines and their side effects has improved by your attending medicines education classes?
  3. Do you feel more confident to discuss mental health conditions with a pharmacist after attending these classes?
  4. Do you feel more confident to discuss treatments and side effects of medication after having attended these classes with a pharmacist?
  5. Do you feel more confident to be involved in discussions about different treatments for your mental health condition with your doctor or pharmacist?
  6. Do you feel medicines education classes are beneficial?
  7. Are you more likely to agree to health monitoring, such as electrocardiograms and blood tests, after attending classes about physical health monitoring?
  8. Are you more likely to agree to take medication after having attended these classes?

Six service users completed the whole course; all responded to the survey after completing the education programme and the Likert scale was used to rate the responses. Service users’ responses were positive:

  • “I have more insight into my illness and all my medication.”
  • “My knowledge with this group has been very satisfactory.”
  • “I am more likely to approach a pharmacist now than before.”
  • “I feel more confident now (to discuss medicines and side effects with a pharmacist).”
  • “I really enjoyed discussions with the pharmacist and the doctor.”
  • “I feel that this group has been beneficial to my therapy.”
  • “I have learned more about my condition and medicines, and this was my favourite ward class.”
  • “I have more awareness of the medicines I need and I understand why it is important to take medication.”
  • “I feel confident to talk to a pharmacist about my health and medication.”
  • “I enjoyed the class very much and would like more classes with the pharmacist.”

All service users questioned would like more medicines and health education classes to be offered in the future. Service users responded positively, either agreeing or strongly agreeing to all questions about their improved knowledge, and discussing health and medication issues with pharmacists in the future. All service users agreed (or strongly agreed) that the medicines education programme was beneficial, and that, having taken the course, they would be more likely to take medication and complete physical health monitoring in the future.

The results of the survey indicate that the pilot programme was successful; however, the sample size surveyed was too small to draw any inference from the data collected.

Service users have responded positively to the classes and have requested more classes be delivered in the future. Further health and medication classes are being developed for physical health conditions, which will be delivered at Woodlands House.

If the education programme is repeated, service users should be surveyed before and after the education programme to measure changes in knowledge and compliance with medication or health-monitoring requirements. This pilot has demonstrated that pharmacists can successfully deliver health education programmes. Similar programmes could be delivered across Oxford Health NHS Foundation Trust for both inpatient and outpatient services.

 

Naeema Majothi,

Pharmacist, pharmacy department, Whiteleaf Centre, Oxford Health NHS Foundation Trust

Citation: Clinical Pharmacist DOI: 10.1211/CP.2018.20204461

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