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.
Eur Neuropsychopharmacol. 2013 Sep;23(9):1057-66. doi: 10.1016/j.euroneuro.2012.11.006. Epub 2012 Dec 6.
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.
重度抑郁症患者的负担较重，且常伴有残疾和较高的医疗费用。药物依从性差会限制抗抑郁药的疗效。社区药剂师（CP）处于帮助患者应对抗抑郁药物治疗的有利地位。本研究旨在评估 CP 干预对开始抗抑郁药物治疗的初级保健患者的影响。新确诊的初级保健患者被随机分配至常规护理组（UC）（92 例）或药剂师干预组（87 例）。患者在 6 个月时进行随访，并在 3 个月和 6 个月时进行 3 次评估。结局测量包括抑郁严重程度（PHQ-9）、健康相关生活质量（EuroQol-5D）和对药房护理的满意度。从计算机化的药房记录中连续记录药物依从性。药物依从性定义为剂量补充不足 80%或药物中断超过 1 个月。干预组患者在 3 个月和 6 个月的随访中更有可能保持依从性，但差异无统计学意义。与 UC 患者相比，干预组患者在主要分析和 PP 分析中均表现出更显著的健康相关生活质量改善，差异具有统计学意义。在临床症状或对药房服务的满意度方面，未观察到统计学差异。我们的研究结果表明，社区药房的简短干预并不能改善抑郁患者的依从性或临床症状。该干预有助于提高患者的健康相关生活质量，这是患者整体状态的综合衡量指标。
