J Am Pharm Assoc (2003). 2024 May-Jun;64(3):102029. doi: 10.1016/j.japh.2024.02.002. Epub 2024 Feb 8.
In the United States, depression is one of the most common mental health disorders. Ambulatory care pharmacists play a critical role in assisting with medication and dosage selection, identifying and managing drug interactions and adverse effects, and increasing medication adherence. Existing data on depression management by ambulatory care pharmacists trained in primary care is limited and outdated.
This study provides insight into current practices for depression management by primary care pharmacy specialists within an academic health center and how pharmacist interventions may impact functional outcomes of depression.
This single-center, retrospective study analyzed 27 patients with a primary care physician within the health system who were seen by an ambulatory care pharmacist for depression. Subjects were excluded if they were under 18 years old, pregnant, or had a diagnosis of bipolar disorder, schizophrenia, schizoaffective disorder, or dementia. The primary outcome was characterization of pharmacist interventions for treatment of depression. Secondary outcomes included change in depressive symptoms, as measured by the patient health questionnaire (PHQ), characterization of adverse effects correlated with medications for depression, and utilization of pharmacogenomics testing and results.
Of 27 patients seen by a pharmacist for depression management, 38 total interventions were made, with an average of 1.77 interventions per patient. The most common intervention was new medication initiation (32%). Average PHQ-9 scores dropped from 14.9 to 7.3 twelve weeks following the initial pharmacist visit. Only 6 patients reported adverse effects to a current antidepressant during their visit with the pharmacist, and only 2 of these cases warranted a change in therapy. Ten patients obtained pharmacogenomic testing with pharmacist facilitation.
Pharmacists in the primary care setting are positioned to be an additional resource for depression management and can offer a wide variety of interventions to improve patient health.
在美国，抑郁症是最常见的精神健康障碍之一。门诊护理药剂师在协助选择药物和剂量、识别和管理药物相互作用和不良反应以及提高药物依从性方面发挥着关键作用。接受过初级保健培训的门诊护理药剂师管理抑郁症的现有数据有限且已过时。
本研究深入了解学术医疗中心中初级保健药房专家管理抑郁症的当前实践，以及药剂师干预措施如何影响抑郁症的功能结果。
这项单中心回顾性研究分析了在医疗系统中有初级保健医生的 27 名抑郁症患者，他们接受了门诊护理药剂师的治疗。如果患者年龄在 18 岁以下、怀孕、或被诊断为双相情感障碍、精神分裂症、分裂情感障碍或痴呆，则将其排除在外。主要结果是描述治疗抑郁症的药剂师干预措施。次要结果包括抑郁症状的变化，用患者健康问卷（PHQ）衡量，与抗抑郁药物相关的不良反应的特征，以及药物基因组学检测和结果的利用。
在 27 名因抑郁症管理而接受药剂师治疗的患者中，共进行了 38 次干预，平均每位患者进行了 1.77 次干预。最常见的干预措施是开始新的药物治疗（32%）。平均 PHQ-9 评分从初始药剂师就诊后的 12 周内从 14.9 降至 7.3。只有 6 名患者在与药剂师就诊时报告了当前抗抑郁药的不良反应，其中只有 2 例需要改变治疗方案。10 名患者在药剂师的协助下进行了药物基因组学检测。
初级保健环境中的药剂师可以成为抑郁症管理的额外资源，并提供各种干预措施来改善患者的健康。
