J Am Pharm Assoc (2003). 2024 May-Jun;64(3):102067. doi: 10.1016/j.japh.2024.102067. Epub 2024 Mar 13.
Depression is a major source of morbidity but often goes undiagnosed. Broader screening is recommended, and pharmacists could contribute.
This study aimed to assess the feasibility of community pharmacy depression and anxiety screening and describe the medication-related problems (MRPs) identified, pharmacist interventions, and provider responses for high-risk patients.
This pilot was conducted between October 2022 and January 2023 at an independently owned community pharmacy in the Midwest United States. Patients aged 18-45 years with ready prescriptions were identified through weekly reports, and tags were placed on prescription bags. A convenience sample of patients fluent in English were offered the Patient Health Questionnaire (PHQ2) and Generalized Anxiety Disorder (GAD2), with follow-up PHQ9 and GAD7 for at-risk individuals. High-risk individuals met with the pharmacist for consultation and recommendations were discussed. Descriptive statistics were calculated for participant demographics, questionnaire responses, MRPs, and provider responses. Patient profiles were examined 2 months after the workup to identify medication changes.
A total of 29 patients volunteered to be screened for anxiety and depression; of these, 41% scored in the high-risk category for depression or anxiety and met with the pharmacist for the consultation. The pharmacist identified multiple MRPs. The most common was the need for additional therapy and inadequate dosages. Patients were reluctant for the pharmacist to follow up with their prescriber and were unreachable for telephone follow-up. Profiles reviewed 2 months after assessment showed half of the at-risk patients had one or more mental health medication changes.
Community pharmacists may have a role in the screening and management of patient mental health, although there were challenges with screening uptake and follow-up. The pharmacist identified multiple MRPs for this high-risk group for which greater routine monitoring and follow-up may be beneficial. More work seems needed to engage both patients and prescribers.
抑郁症是导致发病的主要原因之一，但往往未被诊断。因此推荐扩大筛查范围，药剂师也可以提供帮助。
本研究旨在评估社区药房进行抑郁和焦虑筛查的可行性，并描述识别出的与药物相关的问题（MRPs）、药剂师的干预措施以及高风险患者的医疗服务提供者的反应。
本试点研究于 2022 年 10 月至 2023 年 1 月在美国中西部的一家独立拥有的社区药房进行。通过每周报告识别出有现成处方的 18-45 岁患者，并在处方袋上贴上标签。对英语流利的患者进行患者健康问卷（PHQ2）和广泛性焦虑障碍（GAD2）的便利抽样调查，对高危患者进行 PHQ9 和 GAD7 的后续调查。高危患者与药剂师进行咨询，讨论建议。计算参与者人口统计学、问卷反应、MRPs 和提供者反应的描述性统计数据。在检查后 2 个月检查患者的个人资料，以确定药物变化。
共有 29 名患者自愿接受焦虑和抑郁筛查；其中 41%的患者抑郁或焦虑评分处于高危类别，并与药剂师进行了咨询。药剂师发现了多个与药物相关的问题。最常见的问题是需要额外的治疗和剂量不足。患者不愿让药剂师与他们的医生联系，并且电话随访无法联系到他们。在评估后 2 个月检查的患者资料显示，一半的高危患者有一个或多个心理健康药物变化。
社区药剂师可能在患者心理健康的筛查和管理中发挥作用，尽管筛查参与和后续跟进存在挑战。药剂师为这个高风险群体发现了多个与药物相关的问题，因此更常规的监测和随访可能是有益的。似乎需要做更多的工作来让患者和医生都参与进来。
