PhD defence by Johan Frederik Christensen

Embracing Complexity in Implementing Medication Reviews in Psychiatry

Assessment Committee:
Professor Mikkel Bring Christensen, Department of Clinical Medicine, University of Copenhagen (Chairperson)
Associate professor Daniel Pilsgaard Henriksen, University of southern Denmark
Professor Emma Wallace, University of Cork

Supervisors:
Clinical Professor Gesche Jürgens
Postgraduate Clinical Associate Professor Signe Wegmann Clausen Düring

Department:
Department of Clinical Medicine

Graduate Programme:
Psychiatry

Place:
Building 3, Room: Auditoriet, Fælledvej 6, 4200 Slagelse

Email address to gain access to the thesis: jofch@regionsjaelland.dk 
You will either receive a copy of the thesis or be informed where you can read a physical copy.

Short description of the thesis:
Patients with severe mental disorder may be exposed to excessive polypharmacy. While medication reviews facilitate deprescribing, they do not consistently affect clinical outcomes. This may be caused by medicines optimization being a complex problem involving many stakeholders, medical specialties and professionals while rarely being solved using simple standardized interventions. Employing “complex interventions” to resolve such problems may facilitate direct implementation but are resource intensive. In a localized setting, Health-Technology-Assessments (HTA) may similarly assess the clinical, economic and organizational ramifications of implementing novel interventions while being less resource intensive. Structured as a HTA we implemented physician-led medication reviews through interdisciplinary dialogue for psychiatric outpatients with diabetes to facilitate direct implementation.