Abstract

Introduction

Burnout is an occupational phenomenon resulting from chronic workplace stress that is unsuccessfully managed. Data related to burnout among clinical pharmacists are limited. This study aimed to measure burnout among Board-Certified Psychiatric Pharmacists (BCPPs) and evaluate the correlation between practice characteristics and demographics.

Methods

This was a cross-sectional survey study of BCPPs. The survey included demographic, practice-related, and burnout questions. The primary outcome was burnout scores using the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS [MP]). Secondary outcomes assessed the practice and demographic factors that may have affected burnout levels. Correlation and regression statistics between MBI-HSS (MP) and practice and demographic variables were performed.

Results

Of 571 invitees, 225 participated in the study, and 173 respondents were included. Burnout subscale scores were not significantly different based on age, race, gender, marital, or caregiver status; however, a sense of belonging positively influenced all subscale scores. Regular mentorship and engaging in a hobby were correlated with significantly lower emotional exhaustion scores (20.2 vs 24.8, P = 0.028, and 22.7 vs 28.4, P = 0.010). Burnout subscale scores were comparable between practice settings. However, personal accomplishment subscale scores were significantly lower for pharmacists in the inpatient versus outpatient setting (37.1 vs 38.9, P = 0.036).

Conclusion

BCPPs are at risk for burnout. Race, gender, and patient volume were not associated with burnout. Factors including mentorship, engaging in hobbies, and a sense of belonging were identified as potential modifiers of burnout in BCPPs.

Abstract

Introduction

Board-Certified Psychiatric Pharmacists (BCPPs) are highly trained mental health providers. The workload of clinical pharmacists has been inconsistently reported in the literature. The goals of this study were to quantify the typical and ideal workloads of BCPPs and characterize their practice settings and clinical activities.

Methods

This was a cross-sectional survey study of BCPP members of the American Association of Psychiatric Pharmacists. The survey included demographic, practice-related, and burnout questions. The primary outcome was the self-reported typical and ideal workloads of BCPPs in inpatient, outpatient, and transition-of-care settings. Secondary outcomes included practice settings and types of activities.

Results

Of 571 invitees, 173 respondents were included in the analysis. The mean typical number of patients per day for inpatient and outpatient BCPPs were 35.6 (±22.8) and 9.29 (±10.9), respectively. The mean ideal number of patients per day for inpatient and outpatient BCPPs were 23.6 (±10.4) and 9.96 (±10.6), respectively. Inpatient pharmacists reported spending 15.4 (±12.2) hours on direct patient care and consults during a typical workweek compared with outpatient pharmacists (25.4 ± 15.1, p ≤ .001). A greater number of outpatient pharmacists reported that electronic health record documentation contributed to a significant portion of their workflow compared with inpatient pharmacists (96.2% versus 71.9%, respectively, p ≤ .001).

Discussion

This was the first study to quantify BCPPs self-reported typical and ideal workload in different practice settings. Future research is needed to identify the factors that determine ideal workloads for BCPPs at specific practice sites.

Abstract

Introduction

Delirium affects nearly half of hospitalized older adults and is associated with prolonged hospitalization, dementia, and death. The behavioral manifestations of delirium are generally managed with antipsychotics, but there is growing interest in alternative medical therapy, including guanfacine.

Methods

This retrospective cohort study included patients ≥65 years of age admitted to Maine Medical Center between January 2021 and April 2023 and treated with guanfacine for delirium management on a non-ICU unit. Effectiveness outcomes included antipsychotic use and dose as well as a change in positive delirium screen after guanfacine initiation. Safety outcomes included incidence of hypotension, bradycardia, or transfer to ICU.

Results

A total of 56 patients who received at least 1 dose of guanfacine were evaluated, and 38 patients (68%) with complete data for days −1 to +2 were included in the effectiveness analysis. Before guanfacine initiation, 22/38 patients (58%) were receiving an antipsychotic medication, compared with 18/38 (47%) after guanfacine initiation (p = 0.86). Patients received a median (interquartile range) 6.4 (3.3 to 16) olanzapine equivalents (OE) before guanfacine was initiated and 4.2 (1.7 to 10.0) OE after guanfacine (absolute difference 2.2 OE; relative difference, 34 %; p = 0.8). All 56 patients were included in the safety analysis; 21 (38%) experienced hypotension, and of these, 7 (33%) patients required intervention. Twenty-three (41%) experienced bradycardia while on guanfacine, resulting in 1 patient being transferred to the ICU.

Discussion

Upon initiation of guanfacine, patients with delirium had a reduction in daily antipsychotic exposure and a decrease in positive delirium screens. However, guanfacine was associated with hypotension and bradycardia.

Evaluation of burnout among Board-Certified Psychiatric Pharmacists in the United States

Samantha CatanzanoPharmD, BCPP,

Jennifer N. GemmellaroPharmD, BCPP, BCPS,

Melissa Mooers GrossBS, PharmD, MHA, BCPP, BCPS, BCGP, BCIDP, CPEL, CPPS,

Monica FahmyPharmD, BCPP, BCPS,

Gregory H. PayneMBA, CAE, and

Kelly C. LeePharmD, MAS, BCPP, FCCP

Management of antidepressant-induced bruxism

Evaluation of burnout among Board-Certified Psychiatric Pharmacists in the United States

Abstract

Introduction

Methods

Results

Conclusion

Evaluation of workload among Board-Certified Psychiatric Pharmacists in the United States

Abstract

Introduction

Methods

Results

Discussion

Guanfacine for the management of the behavioral manifestations of delirium in older hospitalized adults

Abstract

Introduction

Methods

Results

Discussion

Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management

Evaluating the efficacy of blister packaging in improving medication adherence within psychiatry: A systematic literature review

Abstract

Introduction

Methods

Results

Discussion

Clozapine plasma level toxicity induced by a pharmacokinetic interaction with bupropion: A case report

Managing ciprofloxacin-clozapine interaction with immunoassay-based monitoring: A case report

Evaluation of burnout among Board-Certified Psychiatric Pharmacists in the United States

Evaluation of workload among Board-Certified Psychiatric Pharmacists in the United States

Management of antidepressant-induced bruxism

Evaluating the efficacy of blister packaging in improving medication adherence within psychiatry: A systematic literature review

Guanfacine for the management of the behavioral manifestations of delirium in older hospitalized adults