Improving patient feedback about and outcomes with antidepressant treatment: a study in eight community pharmacies

Abstract

Objective: To determine (1) whether telephone follow-up using a standardized telemonitoring tool can influence the nature and extent to which antidepressant users provide feedback to pharmacists, (2) whether patient characteristics are associated with the extent of patient feedback, and (3) how patient feedback affects subsequent outcomes after controlling for patient characteristics.

Design: Randomized, controlled, experimental design.

Setting: Eight Wisconsin community pharmacies within a large managed care organization.

Patients: 60 patients presenting new antidepressant prescriptions.

Interventions: Three monthly telephone calls from pharmacists providing structured education and monitoring.

Main outcome measures: Frequency of patient feedback to pharmacists, antidepressant knowledge, beliefs, percentage of missed doses, depression symptom scores, and perceptions of progress.

Results: Compared with usual care patients (n=32), pharmacist-guided education and monitoring (PGEM) patients (n=28) provided significantly more feedback to pharmacists regarding different aspects of their antidepressant therapy even after controlling for patient characteristics. Regression results also showed that patient feedback was significantly associated with greater antidepressant knowledge, positive antidepressant beliefs, and perceptions of progress after 3 months. Patient feedback was unrelated to nonadherence and depressive symptoms.

Conclusion: Structured education and monitoring by pharmacists significantly improves the level of patient feedback to pharmacists, and such feedback may help pharmacists identify and address their patients' misconceptions, concerns, and progress with antidepressant therapy.