VA HSR&D Investigator Insights: Improving Medication Safety for Veterans

[music] My name is Rick Owen. I’m the Director of the Center
for Mental Healthcare and Outcomes Research at the Central Arkansas Veterans
Healthcare System. I’m also the Associate
Chief of Staff for Research at that facility, and I’m a Professor
of Psychiatry at University Arkansas
for Medical Sciences. When I started in Health
Services Research, I was interested in
issues of overprescribing or underprescibing
of medications, antipsychotic medications, which would lead
to bad side effects. At first I was just
observing quality and identifying problems, and then developed interventions
to try to improve care to try to encourage providers to use the
evidence-based practices that were in
practices guidelines. In the late 1990s, my work expanded into
implementation aspects of how do you change practice, how do you get
the best treatments to be actually used
in routine care? And that can involve not
just a simple intervention, but how do you change
an organization? Working with partners helps us to make our work
the most relevant, makes sure that it
doesn’t conflict with other exiting polices
and practices, and also helps us
obtain resources, because if the clinical
side of the house wants to do something, and they are wiling to
provide the resources, or encourage their staff
to work on these things, then it really helps us
to be more effective. We have worked very closely with Mental Health Services
in Central Office, with the Office of
Mental Health Operations, and, as I mentioned, with VISN 16 Mental Health
product line. Some of the things
that have happened as a result of my work and
some of my colleagues’ work, is that we worked with
Mental Health Services. In 2010, we provided a
national training session about medication management and managing the side effects
of antipsychotics, trying to improve
physical healthcare for individuals with
serious mental illness. That program led
to the establishment of a Technical Assistance Center
that was based in Little Rock, so that providers around the
country could call or email and find out about what
the latest tools were or strategies that they
could use in their clinics. A more recent program has been the Psychotropic
Drug Safety Initiative which was developed by the Office of
Mental Health Operations and has been implemented
in the past couple of years. And this includes a measure of antipsychotic
side effect monitoring as well as other measures
related to medication use. So it seems like the
system has acknowledged that this is an important
clinical issue and will continue to work on it. In my work I’ve had
multiple interactions with veterans who
have given input often as part of a group that are reviewing some
education materials, or an intervention or
research priorities. Veterans can given input
about their perspectives on an intervention, or an illness that we’re
trying help them with. They can also tell us what important topics
we might want to work on, and it has been wonderful
to get that perspective. [music]