Madeline C. Salsman

Introduction: Contingency management (CM) is a behavioral intervention that offers incentives to individuals who meet their goals in a substance use disorder (SUD) treatment program. This review highlights CM for abstinence, which is related to abstaining from using a target substance, and CM for adherence, which is related to adherence to receiving injectable medications for SUD. Clinical pharmacist practitioners (CPPs) are well-suited to serve as resources for the growth of CM. Practice Description: Standardized protocols for CM are used across the Department of Veterans Affairs (VA) healthcare facilities involving various interprofessional team members. All patients receiving CM for abstinence or CM for adherence to injectable medications for SUD involving a CPP at 3 VA facilities from November 13, 2017, to December 31, 2023, were retrospectively reviewed to describe patient characteristics and key outcomes. Patients receiving CM for adherence to injectable medications (n = 98) completed 88.3% of appointments on time, with a total of 574 injections of either naltrexone extended-release injection (XR) or buprenorphine XR given. Patients enrolled in CM for abstinence (n = 51) provided 566 total urine samples within the study period, 80% of which were negative for the targeted substance. Conclusion: CPPs are expanding access to CM for abstinence and adherence to injectable medications for SUD, with similar rates of abstinence and adherence seen in the current literature. Continued expansion of the CPP provision of CM in various outpatient settings would further expand access to these evidence-based treatments for patients with SUD.

Introduction: Pharmacists managing psychotropic medications improve clinical and patient-level outcomes across a variety of healthcare settings and diagnoses. The Systematic Literature Review (SLR) Committee of the American Association of Psychiatric Pharmacists published the original paper, known as SLR1, in 2024. This paper served as a comprehensive database, cataloguing the impact of psychiatric pharmacists. The purpose of this paper was to expand the database from SLR1. Methods: A second systematic literature review (SLR2) from January 1, 1961, to December 31, 2024, was conducted using PubMed and search terms based on a previous paper (SLR1). The inclusion criteria required pharmacist intervention focused on psychiatric diagnoses and/or psychotropic medications, as well as evaluation of patient-level outcomes. Exclusion criteria were met if there was no pharmacist intervention, no psychiatric disorder treatment, no clinical outcomes, no original research, no access to full text, and/or no English-language version available. Results: A total of 5883 articles were identified for possible inclusion, with only 466 remaining after screening by title and Another 374 were excluded on the first full-text review. The remaining articles underwent a second full-text review, resulting in 52 articles meeting the inclusion criteria. SLR1 and SLR2 combine for 246 included articles. Discussion: Publication of articles displaying the impact of psychiatric pharmacists has slowed over the past two years, but the overall outcomes were positive, as was also seen in SLR1. The cumulative results of SLR1 and SLR2 support the need for standardization of outcomes and stronger study designs to fully demonstrate the benefit of psychiatric pharmacists.