Pharmacy Focused Education and Outcomes to Improve Patient Care and Management of Schizophrenia Across Practice Settings

It is important that pharmacists are familiar with the substantial health and economic burdens associated with schizophrenia, including high rates of medication nonadherence, to most effectively identify patients who may be ideal candidates for long-acting injectable (LAI) antipsychotics as well as counsel patients/caregivers about schizophrenia and possible treatments. Based on identified knowledge gaps, PTCE developed education to increase pharmacists’ confidence and knowledge about the clinical impact of schizophrenia and their role in utilization of LAIs to improve patient outcomes.

Educational Strategy:

PTCE launched 4 pharmacy-accredited continuing education (CE) programs from 2021 to 2023 for pharmacists including: 1) a print/digital article; 2) AMCP live chapter meetings with live/enduring webinar; 3) a live symposium at CPNP (now AAPP) 2022 with enduring broadcast; and 4) a live symposium at AAPP 2023 with enduring broadcast. Educational objectives were focused on 3 main educational needs: 1) Recognizing the epidemiology of schizophrenia and disease burden; 2) Understanding treatment strategies including the clinical data on LAIs and guidelines on their use; and 3) Identifying strategies to optimize pharmacologic therapy selection for patients with schizophrenia and appropriately counseling patients on their treatment. Participants completed a pretest survey to assess baseline knowledge and confidence as well as a posttest, confidence questions, and planned practice changes.

Patient-Level Outcome(s) Measured:

Data were aggregated in July 2023 for the 4 programs. In all, 7,121 pharmacists completed the activities for credit. Self-identified practice settings included 3,122 (44%) retail, 1,600 (23%) health system/hospital, and 462 (6%) specialty. Additionally, 177 learners have or are preparing for their BCPP, and 288 pharmacists responded that 50% or more of their practice is focused on patients receiving psychiatric care and treatment. Correlating pretest and posttest questions to learning objectives showed knowledge increases from 44% to 58% on epidemiology and disease burden; 40% to 65% for questions on guidelines, clinical data, and LAI treatment strategies; and from 59% to 78% for case-based questions on the role of the pharmacist in patient counseling, transitions of care, and treatment recommendations. Prior to completing the activity, 39% of learners self-reported as moderately, very, or extremely confident in the management of schizophrenia compared with 84% of post-activity learners (P < .001). Furthermore, identified changes to practice were to consider factors associated with nonadherence when evaluating treatment regimens for patients with schizophrenia, to identify patients with schizophrenia who may be experiencing lack of efficacy or safety concerns with current therapies, and to counsel patients about adverse effects to improve adherence to schizophrenia treatments. The identified barriers and challenges that pharmacists face in practice present an opportunity for future education. The top identified barriers are challenges related to insurance coverage of schizophrenia treatments, patient distrust and/or unwillingness to try new therapies, and insurance issues/formulary restrictions/access to treatment.