title: Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: a randomized controlled superiority trial.
abstract: Major depression is associated with high burden, disability and costs. Non-adherence limits the effectiveness of antidepressants. Community pharmacists (CP) are in a privileged position to help patients cope with antidepressant treatment. The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment. Newly diagnosed primary care patients were randomised to usual care (UC) (92) or pharmacist intervention (87). Patients were followed up at 6 months and evaluated three times (Baseline, and at 3 and 6 months). Outcome measurements included clinical severity of depression (PHQ-9), health-related quality of life (HRQOL) (Euroqol-5D) and satisfaction with pharmacy care. Adherence was continuously registered from the computerised pharmacy records. Non-adherence was defined as refilling less than 80% of doses or having a medication-free gap of more than 1 month. Patients in the intervention group were more likely to remain adherent at 3 and 6 months follow-up but the difference was not statistically significant. Patients in the intervention group showed greater statistically significant improvement in HRQOL compared with UC patients both in the main analysis and PP analyses. No statistically significant differences were observed in clinical symptoms or satisfaction with the pharmacy service. The results of our study indicate that a brief intervention in community pharmacies does not improve depressed patients' adherence or clinical symptoms. This intervention helped patients to improve their HRQOL, which is an overall measure of patient status.
authors.affiliation: Research and Development Unit, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Red de Investigación en Actividades Preventivas y Promoción de la Salud en Atención Primaria RedIAPP (RD06/0018/0017), Spain. Electronic address: mrubio@pssjd.org.
authors.forename: Maria
authors.initials: M
authors.lastname: Rubio-Valera
authors.forename: Marian
authors.initials: M
authors.lastname: March Pujol
authors.forename: Ana
authors.initials: A
authors.lastname: Fernández
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Peñarrubia-María
authors.forename: Pere
authors.initials: P
authors.lastname: Travé
authors.forename: Yolanda
authors.initials: Y
authors.lastname: López Del Hoyo
authors.forename: Antoni
authors.initials: A
authors.lastname: Serrano-Blanco
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000592:standards*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010595:Pharmacists / Q000592:standards*; D024382:Professional Role; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents