药师干预对改善抗抑郁药依从性和抑郁症状的效果：系统评价和荟萃分析。
Effect of pharmacist intervention on improving antidepressant medication adherence and depression symptomology: A systematic review and meta-analysis.
机构信息
Department of Interdisciplinary Studies, School of Health Professions, Rutgers, The State University of New Jersey, 65 Bergen St., Newark, NJ 07107, USA.
Department of Interdisciplinary Studies, School of Health Professions, Rutgers, The State University of New Jersey, 65 Bergen St., Room 358, Newark, NJ 07101, USA.
出版信息
Res Social Adm Pharm. 2018 Apr;14(4):321-331. doi: 10.1016/j.sapharm.2017.05.008. Epub 2017 May 22.
BACKGROUND
Depression is a widespread disease with effective pharmacological treatments, but low medication adherence. Pharmacists play a key role in supporting medication adherence in patients with depression given their accessibility to patients.
PURPOSE
The aim of this review was to systematically evaluate the impact of pharmacist interventions on adherence to antidepressants and clinical symptomology among adult outpatients with depressive disorders.
METHODS
A systematic review of controlled trials (both randomized and non-randomized) was conducted. Studies were obtained through a search of PubMed, Academic Search Premier, and Cochrane Library databases. Studies which included a pharmacist intervention to improve medication adherence in outpatients age 17 and above with a depressive disorder diagnosis and antidepressant treatment were included. Twelve publications met inclusion criteria, representing a total of 15,087 subjects: 1379 (9%) intervention and 13,708 (91%) control.
RESULTS
The interventions in each selected publication included some level of in-person counseling and education to promote antidepressant adherence. The pooled odds ratio for medication adherence at 6 months was 2.50 (95% CI 1.62 to 3.86). There were no significant differences noted in subgroup meta-analyses except study location (US, Middle East or Europe) and setting. Only one of the identified studies reported statistically significant impacts of the pharmacist intervention on patient depression symptoms.
CONCLUSIONS
The findings suggest that pharmacist interventions can enhance patient adherence to antidepressant medication in adult outpatients. However, this review failed to demonstrate a positive effect of these interventions on clinical symptoms. Additional longitudinal research is recommended to investigate the multidimensional relationships between pharmacist interventions, patient adherence, and clinical outcomes.
ARTICLE SYNOPSIS
Pharmacists play a key role in supporting medication adherence in patients with depression given their accessibility to patients. The purpose of this review was to systematically evaluate the impact of pharmacist interventions on adherence to antidepressants and clinical symptomology among adult outpatients with depressive disorders. A systematic review of randomized and non-randomized controlled trials was conducted of the twelve studies which met inclusion criteria. The findings suggest that pharmacist interventions can enhance patient adherence to antidepressant medication in adult outpatients. However, this review failed to demonstrate a positive effect of these interventions on clinical symptoms.
背景
抑郁症是一种广泛存在的疾病，有有效的药物治疗方法，但药物依从性低。药剂师可以接触到患者，因此在支持抑郁症患者的药物依从性方面发挥着关键作用。
目的
本综述旨在系统评估药师干预对成年门诊抑郁症患者抗抑郁药依从性和临床症状的影响。
方法
对随机和非随机对照试验进行了系统综述。通过检索 PubMed、Academic Search Premier 和 Cochrane Library 数据库获得研究。纳入的研究为药师干预以提高 17 岁及以上患有抑郁症诊断和抗抑郁治疗的门诊患者药物依从性的研究。共有 12 篇文献符合纳入标准，共计 15087 例患者：1379 例（9%）干预组和 13708 例（91%）对照组。
结果
每篇入选文献中的干预措施都包括一定程度的面对面咨询和教育，以促进抗抑郁药物的依从性。6 个月时药物依从性的合并优势比为 2.50（95%CI 1.62 至 3.86）。除了研究地点（美国、中东或欧洲）和设置外，亚组荟萃分析中没有发现显著差异。只有一项确定的研究报告了药师干预对患者抑郁症状的影响具有统计学意义。
结论
研究结果表明，药师干预可以提高成年门诊患者对抗抑郁药物的依从性。然而，本综述未能证明这些干预措施对临床症状有积极影响。建议进行更多的纵向研究，以调查药师干预、患者依从性和临床结果之间的多维关系。
文章摘要
药剂师可以接触到患者，在支持抑郁症患者的药物依从性方面发挥着关键作用。本综述旨在系统评估药师干预对成年门诊抑郁症患者抗抑郁药依从性和临床症状的影响。对符合纳入标准的 12 项研究进行了随机和非随机对照试验的系统综述。研究结果表明，药师干预可以提高成年门诊患者对抗抑郁药物的依从性。然而，本综述未能证明这些干预措施对临床症状有积极影响。
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