Potential changes impacting psychiatric pharmacy by 2030

Dear Mental Health Clinician Editors,

The American Association of Psychiatric Pharmacists (AAPP) provides a range of education and resources to support psychiatric pharmacists in their clinical practices. In an era of rapid change, AAPP initiated a focus group of volunteers to answer the question, what changes might impact the practice of psychiatric pharmacy in the next 5 years? We would like to share how we went about this and what we found with AAPP members.

The process began with an environmental scanning meeting held on April 6, 2024, in Orlando, Florida, the day prior to the AAPP 2024 annual meeting. The meeting was facilitated by 2 AAPP staff. Invitations were issued to 46 volunteers from all active AAPP workgroups to promote representation across diverse perspectives of the organization (eg, advocacy/education workgroups, practice setting). Thirty-nine invitees attended the focus group meeting (see Table 1 for demographics). The meeting began with asking the above broad question and each participant generating their own list of 5 to 10 likely changes. The group consolidated the approximately 100 ideas down to 17 key changes.

TABLE 1Participant characteristics based on AAPP profile data

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Participants were able to volunteer to lead a small group discussion of any potential change on the list that they deemed important. Over the following 2 hours, small group discussions were conducted on 10 of the 17 changes (Table 2). No participant volunteered to lead discussions on the remaining 7 changes, and these are labeled as “not discussed” in Table 2 with the implication that there was less to be said or less to be done about them. Discussions addressed why the change is important, how the specialty could respond, and when it might happen. The small group leaders documented the discussions within 24 hours, and the resulting 21-page report was circulated to all participants. Finally, using Survey Monkey,¹ participants were asked for each change whether they agreed (on a 5-point Likert scale of “strongly disagree” to “strongly agree”) that it had specific characteristics, including being “inevitable,” “positive for patients,” and other factors useful primarily for AAPP planning. That anonymous survey was live April 7 through 17, 2024, and 32 (82.1%) participants responded.

TABLE 2Changes that might impact the practice of psychiatric pharmacy in the next 5 years

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Potential changes were categorized as clinical (n = 6), practice management (n = 5), administration/payment (n = 2), regulatory (n = 1), or other (n = 3). Interestingly, the group was not unanimous in its categorization of any specific change (eg, no change was universally perceived as being an advocacy issue).

When asked about workforce pipeline challenges, 35.5% responded that the role of the Board-Certified Psychiatric Pharmacist (BCPP) in addressing the change is well-defined or standardized and accepted. All other changes had less than 33% endorsement that the role of the BCPP in addressing the change is well-defined and 9 of them had less than 10%. Clearly, most respondents view the role of the BCPP in all the coming changes as unclear, actively contested, and/or significantly variable.

In light of the above-described changes highlighted by leaders in our field, we psychiatric pharmacists must prepare for what is coming. We recommend that the reader consider the following:

• How are you positioning yourself and your practice, educational efforts, and/or advocacy efforts to align with 1 or more of these changes?

• In what areas are you already well versed?

• What changes will be needed to do the following:

  • Utilize artificial intelligence?

  • Capitalize on use of new medications for optimal patient outcomes?

  • Adapt as genomics and personalized medicine expand?

Beginning to consider how to move in 1 or more of these directions now will help position us all for success in the future. We must also define our role in these areas as psychiatric pharmacists, or others will define our role and set our limitations. Defining our role can be done in many ways, including but not limited to (1) describing yourself as a psychiatric pharmacist to your pharmacist and nonpharmacist colleagues, students, and patients; (2) collecting information to describe the impact you make with your patients, highlighting the ways you improve their access to and quality of care; (3) advocating with your local legislators to let them know what psychiatric pharmacists are, what a difference we make in patient care, and why we should be paid for our efforts; (4) taking ownership to lead the way into and through some of the above changes in your local practice, health system, or trainee education; and (5) aligning your practice with others so that health care systems will see more standardization across BCPP practices.

We will accomplish more by working together. AAPP is already addressing many of these topics^2-9 with continuing education and journal publications. We recommend that the reader engage with AAPP to network with others experiencing the same forces, learn about the changes, share new best practices, and be equipped to move ahead into the future prepared to meet these changes head on.

In closing, psychiatric pharmacists must continue to push forward, doing our best to provide high-quality care to our patients and communities today, also keeping a keen eye on the care provision and educational needs of tomorrow.