J Am Pharm Assoc (2003). 2021 Jul-Aug;61(4S):S154-S160. doi: 10.1016/j.japh.2020.12.011. Epub 2021 Jan 12.
Medication nonadherence is associated with increased morbidity and mortality, higher rates of hospital admissions, and increased health care costs. Nearly half of patients do not take their medications as prescribed leading to poor outcomes. Patients with chronic conditions, especially those with depression, demonstrate lower adherence to their medications. Community pharmacists routinely address demographic and sociocultural barriers and are equipped to screen for and assist with behavioral barriers to medication adherence.
The purpose of this study was to assess the feasibility and impact of conducting a depression screening as part of a holistic adherence assessment. The primary objective of this project was to evaluate the impact of a holistic adherence assessment on medication adherence. The secondary objectives evaluated patients' barriers to adherence, Patient Health Questionnaires 2 and 9 (PHQ-2 and 9) results, and pharmacist interventions.
Pharmacists conducted a holistic adherence assessment and performed a depression screening for patients who were nonadherent or at risk of becoming nonadherent to their chronic medications.
A pharmacist-led holistic adherence assessment implemented in 2 pharmacies of a large community pharmacy chain between January and May 2020.
The impact on medication adherence was evaluated by assessing if patients received the next fill of their chronic medication on time after the holistic adherence assessment.
During the study period, 69 patients completed the holistic adherence assessment and were screened for depression. A total of 12 patients (17.4%) screened positive on the PHQ-2, and 6 patients (8.7%) screened positive on the PHQ-9. After the intervention, 42 patients (60.9%) received the next fill of their targeted chronic medication on time, and 27 patients (39.1%) were late to pick up their next fill.
The results illustrated that community pharmacists can incorporate a depression screening into a holistic adherence assessment effectively to screen for behavioral barriers that may affect medication adherence.
药物依从性差与发病率和死亡率增加、住院率升高以及医疗保健成本增加有关。近一半的患者没有按照规定服用药物，导致治疗效果不佳。患有慢性病的患者，尤其是患有抑郁症的患者，对药物的依从性较低。社区药剂师通常会解决人口统计学和社会文化障碍问题，并且有能力筛查和协助解决药物依从性的行为障碍。
本研究旨在评估作为整体依从性评估的一部分进行抑郁症筛查的可行性和影响。该项目的主要目的是评估整体依从性评估对药物依从性的影响。次要目标评估了患者对药物的依从性障碍、患者健康问卷 2 和 9（PHQ-2 和 9）的结果以及药剂师的干预措施。
药剂师对不依从或有不依从风险的慢性药物患者进行整体依从性评估和抑郁症筛查。
2020 年 1 月至 5 月，在一家大型社区连锁药店的 2 家药店实施了由药剂师主导的整体依从性评估。
通过评估患者在整体依从性评估后是否按时领取下一次慢性药物来评估对药物依从性的影响。
在研究期间，共有 69 名患者完成了整体依从性评估并接受了抑郁症筛查。共有 12 名患者（17.4%）PHQ-2 筛查呈阳性，6 名患者（8.7%）PHQ-9 筛查呈阳性。干预后，42 名患者（60.9%）按时领取了下一次靶向慢性药物，27 名患者（39.1%）延迟领取下一次药物。
结果表明，社区药剂师可以有效地将抑郁症筛查纳入整体依从性评估中，以筛查可能影响药物依从性的行为障碍。
