title: Pharmacist-patient communication on use of antidepressants: a simulated patient study in community pharmacy.
abstract: BACKGROUND
  Effective communication between community pharmacists and patients, particularly with a patient-centered approach, is important to address patients' concerns relating to antidepressant medication use. However, few studies have investigated community pharmacists' communication behaviors in depression care.
  
  
  OBJECTIVE
  To characterize community pharmacist-patient interactions during consultations involving use of antidepressants.
  
  
  METHODS
  Twenty community pharmacists received 3 simulated patient visits involving issues related to the use of antidepressants: 1) patient receiving a first-time antidepressant prescription; 2) patient perceiving lack of efficacy of antidepressants after 2 weeks of treatment, and 3) patient intending to discontinue treatment prematurely. All 60 encounters were audio-recorded and analyzed using the Roter Interaction Analysis System (RIAS), a quantitative coding system that characterizes communication behaviors through discrete categories. A patient-centeredness score was calculated for each encounter.
  
  
  RESULTS
  The majority of pharmacist communication was biomedical in nature (50.7%), and focused on providing therapeutic information and advice on the antidepressant regimen. In contrast, only 5.4% of pharmacist communication was related to lifestyle/psychosocial exchanges. There were also few instances of emotional rapport-building behaviors (8.6%) or information gathering (6.6%). Patient-centered scores were highest in the scenario involving a first-time antidepressant user, as compared to other scenarios involving issues with continued therapy.
  
  
  CONCLUSIONS
  Community pharmacists appeared to adopt a "medication-centered" approach when counseling on antidepressant issues. There is scope for improvement in patient-centered communication behaviors, particularly lifestyle/psychosocial discussions, facilitating patient participation, and emotional rapport-building. The RIAS appears suited to characterize brief consultations in community pharmacies and can provide a framework in guiding communication training efforts. Further research is needed to assess the impact of pharmacist communication behaviors on patient care outcomes.
authors.affiliation: The University of Sydney, NSW 2006, Australia; Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia. Electronic address: weiwen.chong@sydney.edu.au.
authors.forename: Wei Wen
authors.initials: WW
authors.lastname: Chong
authors.affiliation: The University of Sydney, NSW 2006, Australia.
authors.forename: Parisa
authors.initials: P
authors.lastname: Aslani
authors.affiliation: The University of Sydney, NSW 2006, Australia.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Chen
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001315:Australia; D003142:Communication; D003376:Counseling; D003863:Depression / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010594:Pharmacies; D010595:Pharmacists; D011369:Professional-Patient Relations; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressant adherence; Patient-centeredness; Pharmacist–patient communication; Roter Interaction Analysis System