Shaping Psychiatric Pharmacy Through Stewardship and Standardized Outcomes

This work was sponsored by American Association of Psychiatric Pharmacists (AAPP) The American Association of Psychiatric Pharmacists (AAPP) has sought to operationalize the concept of psychotropic stewardship through formalizing a consensus-based set of outcomes and measurements to improve practice standardization. AAPP’s aim is to aid in developing psychotropic stewardship programs (PSPs) via the framework of eight core implementation elements and the utilization of standardized outcomes – which were inspired by the quadruple aim of health care. Based on the standards developed during the advent of antimicrobial stewardship programs, AAPP’s vision for PSPs includes strengthening awareness in psychotropic prescribing through an interdisciplinary team approach and for all patients to receive, and maintain, safe and appropriate use of psychotropic medications. Patients receiving care with PSPs should be based on risk stratification, site-specific needs, and available local opportunities. Initial identification could prioritize individuals with polypharmacy, high-risk psychotropics, transitions of care, or co-occurring disorders/disease states. To aid in optimization, success probability, and progress reporting of PSPs, the development and use of core standardized psychiatric outcomes were composed. These selected outcomes, and respective measurements, were founded from AAPP’s comprehensive systematic literature review. The outcomes were peer reviewed and ultimately were included upon once achieving consensus. AAPP’s future goals include additional refinement to proposed PSP models, assessing and modifying currently identified core outcomes, developing a logic model, and to begin the conceptual introduction of PSP to a broader audience. AAPP has committed support to healthcare systems and institutions who have identified an interest in further developing a PSP and/or the utilization of a core outcome set.