Īnother systematic review which evaluated the quantity and quality of medical literature examining the impact of pharmacists in mental health care from 1972 to 2003 reported that there were improvements in outcomes, prescribing practices, patient satisfaction, and resource use when pharmacists are involved in mental health care. In these studies, clinical pharmacists also educated the patients with mental disorders and other health care professionals. In a review of clinical pharmacy services offered in mental health care conducted by Richardson et al., 18 hospital-based studies were identified in which interventions conducted by clinical pharmacists during patient medication chart reviews, laboratory investigation result assessment, and prescription of medications were identified. Pharmacists spearhead medication adherence and are involved in education on primary prevention of mental illnesses, health promotion, and lifestyle modification. In addition, pharmacists are available to provide comprehensive drug information to patients with mental illnesses such as schizophrenia, the patient relatives, and other health care professionals involved in patient management. In ensuring the safe and efficacious use of medications, clinical pharmacists are also pivotal. Clinical pharmacists as such contribute to patient care by playing a vital role in the detection, resolution, and prevention of medication-related problems. Since pharmacists are authorities in pharmaceutical care, they also apply their complementary skills and knowledge in managing patients with mental illnesses together with other health care professionals in the multidisciplinary team. Clinical pharmacists have been instrumental in several roles such as being educators, consultants, and providers for over 30 years. Management of patients with conditions such as schizophrenia is generally a collaborative effort which encompasses incorporation of skills of a myriad of health care professionals involved in patient care. Pharmacists are therefore indispensable in improving the quality of service rendered to patients with mental illnesses such as schizophrenia which contributes to reduction of the numerous problems associated with and faced by patients with mental disorders. Medications are invaluable in the management of patients with mental illnesses. Since schizophrenia is a chronic illness that influences virtually all aspects of life of affected persons, treatment planning has three goals which are to reduce or eliminate symptoms, to maximize quality of life and adaptive functioning, and to promote and maintain recovery from the debilitating effects of illness to the maximum extent possible. Common experiences include hallucinations mostly involving hearing voices or seeing things that are not there and delusions which involve having fixed, false beliefs.
Schizophrenia is a chronic and severe mental disorder affecting more than 21 million people worldwide which is characterized by distortions in thinking, perception, emotions, language, sense of self, and behaviour. The case proves that it is critical for clinical pharmacists to be involved in the multidisciplinary team during management of patients with psychosis.
Interventions by the clinical pharmacists contributed to improvement in the patient’s symptoms prior to hospital discharge.
Issues raised by clinical pharmacists during the patient’s admission included need for alternative medication for rapid tranquilization, need for initial investigations and documentation of the patient’s vitals, initiation of antipsychotic therapy without initial monitoring and screening for substance abuse, inappropriate dose at initiation of antipsychotic medications, untreated indication, and incidence of missed doses. Medications administered to the patient while on admission included IV diazepam, IM haloperidol, IV Ketamine, IM flupentixol, olanzapine tablets, and trihexyphenidyl tablets. Key interventions offered included rapid tranquilization, electroconvulsive therapy, and psychotherapy. The patient was referred to the psychiatric unit of a hospital and diagnosed with schizophrenia. A gainfully employed young African male adult reported to be roaming around town moving from one bank to another was arrested. This report presents the role of clinical pharmacists in the management of a patient diagnosed with schizophrenia with symptoms of paranoia. Schizophrenia is a chronic and severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behaviour.