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药剂师干预对抑郁症患者依从性和可测量的患者结局的影响:一项随机对照研究。

Impact of pharmacist intervention on adherence and measurable patient outcomes among depressed patients: a randomised controlled study.

作者信息

Aljumah K, Hassali M A

机构信息

Department of Pharmacy, Al-Amal Psychiatric Hospital, P.O. Box 33626, Riyadh, 11458, Saudi Arabia.

School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.

出版信息

BMC Psychiatry. 2015 Sep 16;15:219. doi: 10.1186/s12888-015-0605-8.

Abstract

BACKGROUND

Adherence to antidepressant treatment is essential for the effective management of patients with major depressive disorder. Adherence to medication is a dynamic decision-making process, and pharmacists play an important role in improving adherence to antidepressant treatment in different settings within the healthcare system. The aim of this study was to assess whether pharmacist interventions based on shared decision making improved adherence and patient-related outcomes.

METHODS

This was a randomised controlled study with a 6-month follow-up. Participants were randomly allocated to two groups: 1) intervention group (IG) (usual pharmacy services plus pharmacist interventions based on shared decision making); or 2) control group (CG) (usual pharmacy services). Recruited patients fulfilled the following inclusion criteria: aged 18 to 60 years diagnosed with a major depressive disorder, and no history of psychosis or bipolar disorders. A research assistant blinded to the group allocations collected all data.

RESULTS

Two hundred and thirty-nine patients met the inclusion criteria and were randomised to the IG (n = 119) or CG (n = 120). Nineteen patients dropped out of the study during the follow-up phase. After 6 months, patients in the IG had significantly more favorable medication adherence, treatment satisfaction, general overuse beliefs, and specific concern beliefs. However, the groups did not differ in severity of depression or health-related quality of life after 6 months.

CONCLUSIONS

Our findings emphasise the important role of pharmacists in providing direct patient care in regular pharmacy practice to improve adherence to medications and other patient-reported outcomes.

TRIAL REGISTRATION

ISRCTN34879893, Date assigned: 30/12/2014.

摘要

背景

坚持抗抑郁治疗对于有效管理重度抑郁症患者至关重要。坚持服药是一个动态的决策过程,药剂师在改善医疗保健系统不同环境下的抗抑郁治疗依从性方面发挥着重要作用。本研究的目的是评估基于共同决策的药剂师干预是否能提高依从性及与患者相关的结局。

方法

这是一项为期6个月随访的随机对照研究。参与者被随机分为两组:1)干预组(IG)(常规药房服务加基于共同决策的药剂师干预);或2)对照组(CG)(常规药房服务)。招募的患者符合以下纳入标准:年龄在18至60岁之间,被诊断为重度抑郁症,且无精神病或双相情感障碍病史。一名对分组情况不知情的研究助理收集了所有数据。

结果

239名患者符合纳入标准,被随机分配到IG组(n = 119)或CG组(n = 120)。19名患者在随访阶段退出了研究。6个月后,IG组患者在药物依从性、治疗满意度、一般过度用药信念和特定担忧信念方面明显更有利。然而,6个月后两组在抑郁严重程度或健康相关生活质量方面没有差异。

结论

我们的研究结果强调了药剂师在常规药房实践中提供直接患者护理以提高药物依从性和其他患者报告结局方面的重要作用。

试验注册

ISRCTN34879893,分配日期:2014年12月30日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ff/4574071/653732f65870/12888_2015_605_Fig1_HTML.jpg

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