TY  - CHAP
M1  - Book, Section
TI  - Assessment of Psychiatric Disorders
A1  - Schneiderhan, Mark E.
A1  - Nelson, Leigh Anne
A1  - Bauer, Steven
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
Y1  - 2017
N1  - 
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Patient  Care  Process  for  Psychiatric  AssessmentCollect:Patient  characteristics  (eg,  age,  sex,  pregnant)Current  medications  including  OTC  aspirin/NSAID  use,  herbal  products,  and  dietary  supplementsPast  medication  history,  including  medications  not  tolerated  and  any  allergies  to  medicationsCurrent  and  past  medical/psychiatric  history  (personal  and  family)Social  history  (eg,  tobacco/ethanol  use)  and  dietary  habitsOverall  functional  statusObjective  dataBlood  pressure  (BP),  heart  rate  (HR),  respiratory  rate  (RR),  weightLabs  including  glucose,  lipids,  Complete  Blood  Counts  (CBCs),  serum  drug  levels,  and  pharmacogenetic  testing  results  if  available.Psychiatric  rating  scales,  Psychological  tests,  and  suicide  assessmentAssess:Cognitive  and  Emotional  status  (eg.Mental  Status  Examination  and  presence  of  anxiety,  depression)Vitals:  (eg,  systolic/diastolic  blood  pressures,  heart  rate,  and  weight  (BMI))Presence  of  physical  conditions  that  may  overlap  psychiatric  conditions  or  medication  side-effects  (eg,  pain,  nausea,  vomiting,  constipation,  edema,  tremors,  headaches,  dizziness,  and  etc.)Presence  of  stress  or  possible  stressors  (eg,  suicidality,  recent  surgery,  pregnancy,  estrogen  use,  and  recent  hospitalizations)Ability/willingness  to  seek  additional  psychiatric  support  (eg,  therapy,  outpatient  groups,  hospitalization,  and  etc.)Ability/willingness  to  follow-up  with  psychiatry  services  including  medication  management,  psychotherapy  and/or  substance  use  disorder  treatment  if  indicated,  and  primary  care  around  medical  conditions.Prior  medication  adherencePharmacogenomics  testing  resultsPlan:*Drug  therapy  regimen  including  specific  psychiatric  medication(s),  dose,  route,  frequency,  and  duration.Monitoring  parameters  including  efficacy  (eg,  serum  drug  monitoring,  ,  pain  assessment,  and  safety  plan  (eg,  calling  911)Patient  education  (eg,  purpose  of  treatment,  dietary  and  lifestyle  modification,  drug-specific  information,  medication  administration/adherence  techniques,  and  review  results  of  laboratory/pharmacogenetic  test  results)Patient  education  around  self-monitoring  for  resolution  of  mental  health  symptoms,  when  to  call  the  clinic  with  questions  and  concerns,  and  when  to  seek  emergency  medical  attention  (eg,  suicidality).Obtain  release  of  information  to  obtain  collateral  information  (eg,  family  members,  case  managers,  therapists,  medical  providers,  and  etc.)Send  letters  and/or  copies  of  progress  notes  to  healthcare  clinicians  who  are  also  providing  medications  or  other  therapies  when  appropriate  (eg,  starting  new  medications,  concerns  about  possible  side-effects,  and  etc.).Make  referrals  to  other  providers  when  appropriate  (eg,  psychologist,  social  worker,  neurologist,  pain  specialist,  dietician,  and  substance  use  disorder  (addictions)  treatment)Implement:*Provide  verbal  and  written  patient  education  regarding  all  elements  of  treatment  planUse  motivational  interviewing  and  coaching  strategies  to  maximize  adherenceSchedule  follow-up  to  monitor  and  assess  medication  effectiveness  (eg,  PHQ-9,  serum  drug  levels),  adherence  assessment  of  all  recommendationsFollow-up:  Monitor  and  Evaluate:Resolution  of  behavioral  health  symptoms  (eg,  utilizing  rating  scales  at  every  patient  care  encounter)Presence  of  adverse  medication  side-effects  and  changing  medical  condition  statusPatient  adherence  to  treatment  plan  using  multiple  sources  of  information  (eg,  medication  refill  records,  medication  administration  records,  serum  drug  levels,  and  etc.)Re-evaluate  treatment  plan  at  least  every  1-3  months.  Consider  scheduling  early  (2  weeks)  or  more  frequent  follow-up  visits  after  starting  new  drug  therapy  or  monitoring  behavioral  risks  such  as  suicidality.*Collaborate  with  patient,  caregivers,  and  other  health  professionals  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/23
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1157515741
ER  -