Identifying the scope and nature of enquiries and demand for medicines information within children and young people services at a large mental health NHS trust: a service evaluation

Abstract Introduction Adolescent mental health disorders affect around one in seven young people worldwide, and demand for child and adolescent mental health services (CAMHS) in the UK has more than doubled in recent years.1,2 Psychotropic prescribing for young people is complex due to limited evidence, off-label use, and need for careful monitoring. Multidisciplinary teams, including non-medical prescribers (NMPs), therefore require timely medicines information (MI) support. Despite established MI activity in adult and acute paediatric settings, little is known about MI demand within CAMHS and community paediatrics. The researcher is a CAMHS specialist pharmacist (not MI based) and this evaluation aimed to understand the nature of medicines-related enquiries within their service to inform future support needs. Aim To evaluate the nature, complexity, and volume of medicines-related enquiries submitted by healthcare professionals across CAMHS and community paediatric services. Methods A retrospective service evaluation was undertaken for enquiries submitted between 1 June 2024 and 1 June 2025. All medicines-related queries received via the pharmacy email inbox were included. Enquiries were manually saved into a dedicated folder and formed the data source. Data extraction and analysis were conducted by the pharmacist who also answered the enquiries, introducing potential bias; this is acknowledged. Extracted data included professional group, service, topic, medicine(s), urgency, complexity, and outcome. Complexity was categorised using the UKMI Framework. Where relevant, outcomes were identified through review of the patient’s electronic health record with manual linkage using patient identifiers. ‘Practical queries’ referred to administration-related issues such as formulation choice, timing, or product switching. Descriptive statistics were used. The MI Databank was not utilised as CAMHS/CYPF enquiries received were out with the Trust MI service and therefore not logged within the national MI databank system. Generative artificial intelligence was used to condense the abstract fit the word limit. Results Forty-three enquiries were identified (CAMHS n = 10, 23%; CYPF n = 33, 77%). Nurses (n = 17, 40%) and NMPs (n = 12, 28%) submitted the highest proportion, followed by doctors (n = 8, 19%). Attention Deficit Hyperactivity Disorder (ADHD) related enquiries accounted for 58% (n = 25). Common topics included drug interactions (n = 17, 40%), contraindications or precautions (n = 11, 26%), and practical queries (n = 6, 14%). Enquiry complexity was categorised as simple (n = 22, 51%), moderate (n = 17, 40%), and complex (n = 4, 9%). Urgency ratings were low (n = 11, 26%), medium (n = 20, 47%), and high (n = 12, 28%). Identified outcomes indicate pharmacy advice influenced treatment initiation (n = 9), monitoring (n = 5), counselling (n = 5), dose change (n = 1), drug choice change (n = 1), decisions not to initiate (n = 2), and dose/switch/referral (n = 1). Undocumented outcomes equated to 37% (n = 16) with no changes made in three cases. Conclusion This evaluation provides an insight into demand for medicines advice within CAMHS and community paediatric services, highlighting reliance on pharmacist expertise, particularly for ADHD and psychotropic decision-making. The nurses and NMPs frequently seek advice suggesting a particular need for support within this professional group. The absence of a standardised MI recording system limited data completeness. Implementing a structured enquiry-logging process could strengthen governance and support service development. Further work could assess wider applicability across CAMHS services nationally.