Enhancing Quality in Psychiatry with Psychiatrists (EQUIPP)--results from a pilot study.

Objectives: To pilot a pharmacist-led, patient centered medication management program.

Design: Prospective, single arm trial.

Setting: Academic geriatric psychiatry outpatient clinic.

Participants: Outpatients at least 65 years old, proxy available if demented, and on two or more psychiatric medications.

Intervention: A clinical pharmacist completed a baseline medication review and made evidence-based recommendations that were implemented by the pharmacist after discussion with the physician. The pharmacist made a minimum of monthly contact for 6 months to review medications and related issues.

Measurements: The primary outcome was the change in number of medication related problems over time (3 and 6 months) as defined by a predetermined classification system.

Results: The mean age of the 27 patients was 75 years, 10 of whom required a proxy to participate. On average, patients had nine chronic conditions and were taking 14 medications. The mean number (SD; range) of medication related problems at baseline was 4.1 (2.2; 0-8) and at 3 and 6 months were 3.6 (2.4, 0-9) and 3.4 (2.1; 0-8), respectively. Most follow-up problems were new (80% and 89% at 3 and 6 months, respectively).

Conclusion: Using a pharmacist to deliver a medication management program was feasible and addressed existing problems. New problems, however, developed over a short interval (3-6 months), suggesting that ongoing intervention is required.