The clinical impact of pharmacist services on mental health collaborative teams: A systematic review

Objective: To evaluate the clinical impact of mental health collaborative teams that include pharmacists. Data sources: PubMed, PsychInfo, Clinialtrials.gov, International Pharmaceutical Abstracts. Study selections: Studies in which pharmacists were part of a mental health collaborative team (defined as 2 or more health care providers working together to provide enhanced mental health care services to patients), mental health clinical outcomes were measured with a validated tool, and the articles were written in English were included. Articles were searched from database inception to July 2019 and were excluded if a quantifiable comparison of mental health clinical outcomes was not included or collaboration was not described. Data extraction: Two authors independently screened titles and abstracts for relevance. Full-text articles that potentially met inclusion criteria were retrieved, read, and evaluated for inclusion using the eligibility criteria. Results: All 9 included studies reported improvements in mental health clinical outcomes when using collaborative teams that included pharmacists. Depression (n = 8) and post-traumatic stress disorder (PTSD) (n = 1) were the mental health conditions included in the studies. Overall, 5 of 7 of the randomized controlled trials (RCTs) had statistically significant improvement in mental health clinical outcomes between the intervention groups, which included the collaborative teams and a "usual care" groups, which did not. Four of the 5 studies were set in Veterans Affairs (VA) clinics. The 2 non-RCT pre-post studies showed improvements in clinical outcomes but did not achieve statistical significance. Conclusion: Evidence shows that collaborative teams that include pharmacists are effective at improving mental health outcomes in patients with depression and PTSD. Future studies should include non-VA settings and other mental health conditions to understand pharmacists' impact more broadly in mental health collaborative teams. Clarifying and understanding the overlapping roles and responsibilities of members of the team may be the next step to continue improving mental health clinical outcomes. (C) 2020 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.