Al-Jumah Khalaf Ali, Qureshi Naseem Akhtar
Specialist Pharmacist, Al-Amal Mental Health Complex, Riyadh.
Patient Prefer Adherence. 2012;6:87-100. doi: 10.2147/PPA.S27436. Epub 2012 Jan 31.
Pharmacist intervention in improving patient adherence to antidepressants is coupled with better outcomes.
The aim of this investigation was to systematically examine the published literature to explore different types of pharmacist interventions used for enhancing patient adherence to antidepressant medications. Three specific questions guided the review: what is the impact of pharmacist interventions on adherence to antidepressant medication? What is the impact of pharmacist interventions on patient-reported outcomes and patient satisfactions? What are the types of interventions used by pharmacists to enhance patients' adherence to antidepressants?
A systematic review of the literature was conducted during August-November 2010 using PubMed, BIOSIS Previews(®) Web of Science, ScienceDirect, the Cochrane Library, PsycINFO(®), IngentaConnect™, Cambridge Journals Online, and Medscape databases. Key text words and medical subject headings included pharmacist intervention, medication intervention, depression, medication adherence, health-related quality of life, patient-reported outcomes, and antidepressants.
A total of 119 peer-reviewed papers were retrieved; 94 were excluded on the basis of abstract review and 13 after full-text analysis, resulting in twelve studies suitable for inclusion and intensive review. The most common intervention strategy that pharmacists utilized was a combination of patient education and drug monitoring. A cumulative patient adherence improvement in this review ranged from 15% to 27% attributed to utilization of different interventions and different combinations of interventions together with patient satisfaction with the treatment when depression improved.
This review suggests that pharmacist intervention is effective in the improvement of patient adherence to antidepressants. This may be a basis for more studies examining the effectiveness of innovative interventions by pharmacists to enhance patient adherence to antidepressant medications.
药剂师干预可提高患者对抗抑郁药的依从性，并带来更好的治疗效果。
本研究旨在系统审查已发表的文献，以探索用于提高患者对抗抑郁药物依从性的不同类型药剂师干预措施。本次综述由三个具体问题指导：药剂师干预对抗抑郁药物依从性有何影响？药剂师干预对患者报告的结局和患者满意度有何影响？药剂师用于提高患者对抗抑郁药依从性的干预措施类型有哪些？
2010年8月至11月期间，使用PubMed、BIOSIS Previews(®) Web of Science、ScienceDirect、Cochrane图书馆、PsycINFO(®)、IngentaConnect™、剑桥期刊在线和Medscape数据库对文献进行了系统综述。关键词和医学主题词包括药剂师干预、药物干预、抑郁症、药物依从性、健康相关生活质量、患者报告的结局和抗抑郁药。
共检索到119篇经同行评审的论文；基于摘要评审排除94篇，全文分析后排除13篇，最终有12项研究适合纳入并进行深入综述。药剂师使用的最常见干预策略是患者教育与药物监测相结合。在本综述中，由于采用了不同的干预措施以及不同干预措施的组合，同时患者对抑郁症改善后的治疗感到满意，患者的累积依从性提高了15%至27%。
本综述表明，药剂师干预在提高患者对抗抑郁药的依从性方面是有效的。这可能为更多研究药剂师创新干预措施提高患者对抗抑郁药物依从性的有效性提供依据。
