Guillaumie Laurence, Ndayizigiye Alice, Beaucage Clément, Moisan Jocelyne, Grégoire Jean-Pierre, Villeneuve Denis, Lauzier Sophie
Population Health and Optimal Practices in Health Research Unit (Guillaumie, Moisan, Grégoire, Lauzier), CHU de Québec-Université Laval Research Centre.
Faculty of Nursing (Ndayizigiye, Guillaumie), Université Laval.
Can Pharm J (Ott). 2018 Feb 9;151(2):142-148. doi: 10.1177/1715163518755814. eCollection 2018 Mar-Apr.
Patients prescribed antidepressant drug treatment (ADT) for major depression report several needs in relation to their treatment, and a large proportion of these patients will end ADT prematurely. Community pharmacists may play an important role in monitoring ADT and supporting these patients. However, little is known about patient experiences of the services provided in community pharmacies. The objectives of this study were to 1) explore patients' experiences with the services community pharmacists provide for ADT and 2) identify potential avenues for improvement of pharmacists' services within the context of ADT.
A qualitative descriptive exploratory study was conducted among individuals diagnosed with major depression who had initiated ADT at some point in the 12 months prior to their participation in the study. A total of 14 persons recruited in a local health centre and a community-based organization participated in individual interviews. A thematic analysis of the interview transcripts was conducted.
Pharmacists tend to concentrate their involvement in treatment at initiation and at the first refill when questions, uncertainties and side effects are major issues. Patients felt that the pharmacists' contributions consisted of providing information and reassurance; in these respects, their needs were met. Participants had few ideas as to what additional services pharmacists could implement to improve patients' experience with ADT. Patients' sole expectations were that pharmacists extend this information role to the whole length of the treatment and enhance the confidentiality of discussions in pharmacy.
Pharmacists should provide counselling throughout the entire treatment rather than passively waiting for patients to ask their questions. However, facilitation of open discussions may not be achieved unless confidentiality at pharmacies is secured.
接受抗抑郁药物治疗（ADT）的重度抑郁症患者报告了与治疗相关的多种需求，并且这些患者中有很大一部分会过早结束ADT治疗。社区药剂师在监测ADT治疗及支持这些患者方面可能发挥重要作用。然而，对于社区药房所提供服务的患者体验知之甚少。本研究的目的是：1）探究患者对社区药剂师提供的ADT治疗服务的体验；2）在ADT治疗背景下确定改善药剂师服务的潜在途径。
对在参与研究前12个月内的某个时间点开始接受ADT治疗的重度抑郁症患者进行了一项定性描述性探索性研究。在当地健康中心和一个社区组织招募的14人参与了个人访谈。对访谈记录进行了主题分析。
药剂师往往将其对治疗的参与集中在开始治疗时和首次续药时，此时问题、不确定性和副作用是主要问题。患者认为药剂师的贡献包括提供信息和安慰；在这些方面，他们的需求得到了满足。参与者对于药剂师可以实施哪些额外服务来改善患者的ADT治疗体验几乎没有想法。患者唯一的期望是药剂师将这种信息提供的角色扩展到整个治疗过程，并加强在药房讨论的保密性。
药剂师应在整个治疗过程中提供咨询，而不是被动等待患者提问。然而，除非药房的保密性得到保障，否则可能无法促进开放的讨论。
