Defining pharmacist’s role in optimizing prescription digital therapeutics for patients with schizophrenia: A modified Delphi consensus perspective

Background As recognized members of the mental healthcare team, pharmacists are uniquely positioned to support use of prescription digital therapeutics (DTx) for schizophrenia. However, their specific role in care is yet to be clarified.Objectives To develop recommendations for how pharmacists can embed prescription DTx within healthcare systems, improve access to and engagement with these treatments.Methods A modified Delphi approach captured US pharmacists' perspectives on prescription DTx for schizophrenia. A 4-member expert steering committee developed a consensus framework on scale, access, and data to inform the creation of an online survey. Ten pharmacy experts with mental- and digital-health experience (average experience: 23.7 years) completed the survey and its results were used to formulate 24 Delphi panel questions (17 yes/no; 7 multiple-choice). Pharmacy experts and steering committee members (N=14) voted on the Delphi panel questions. Consensus was defined as ≥70% agreement. Questions failing to reach consensus statements in round 1 were discussed and subjected to a second vote. If consensus was not achieved after round 2, "no consensus achieved" was documented and the highest-voted category was noted.Results Consensus statements were achieved on 20/24 (83%) questions (scale, n=8; access, n=10; data, n=2). Of these, 17/20 (85%) questions achieved consensus statements after one voting round; 3/20 (15%) required a second round. Four questions did not achieve consensus statements. The accepted statements informed recommendations regarding pharmacists' involvement in optimizing prescription DTx use for schizophrenia.Conclusion Recommendations included: Pharmacists can facilitate expanding scale by supporting integration of prescription DTx into pharmacy systems and addressing adoption barriers through prescriber education and partnerships; support access by being involved when a prescription DTx is introduced to a patient; and leverage clinical data that are a priority to stakeholders to drive awareness, usage, and adoption.