Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis

BACKGROUND: Pharmacists can play a decisive role in the management of ambulatory patients with depression who have poor adherence to antidepressant drugs. OBJECTIVE: To systematically evaluate the effectiveness of pharmacist care in improving adherence of depressed outpatients to antidepressants. ME...

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Autores: Rubio Valera, Maria, Serrano Blanco, Antoni, Magdalena Belío, Jesús, Fernández Sánchez, Ana, García Campayo, Javier, March Pujol, Marian, López del Hoyo, Yolanda
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2011
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/52204
Acceso en línea:https://hdl.handle.net/2445/52204
Access Level:acceso abierto
Palabra clave:Depressió psíquica
Serveis farmacèutics
Cooperació dels malalts
Antidepressius
Atenció primària
Metaanàlisi
Mental depression
Pharmaceutical services
Patient compliance
Antidepressants
Primary health care
Meta-analysis
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spelling Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysisRubio Valera, MariaSerrano Blanco, AntoniMagdalena Belío, JesúsFernández Sánchez, AnaGarcía Campayo, JavierMarch Pujol, MarianLópez del Hoyo, YolandaDepressió psíquicaServeis farmacèuticsCooperació dels malaltsAntidepressiusAtenció primàriaMetaanàlisiMental depressionPharmaceutical servicesPatient complianceAntidepressantsPrimary health careMeta-analysisBACKGROUND: Pharmacists can play a decisive role in the management of ambulatory patients with depression who have poor adherence to antidepressant drugs. OBJECTIVE: To systematically evaluate the effectiveness of pharmacist care in improving adherence of depressed outpatients to antidepressants. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. RCTs were identified through electronic databases (MEDLINE, Cochrane Central Register of Controlled Trials, Institute for Scientific Information Web of Knowledge, and Spanish National Research Council) from inception to April 2010, reference lists were checked, and experts were consulted. RCTs that evaluated the impact of pharmacist interventions on improving adherence to antidepressants in depressed patients in an outpatient setting (community pharmacy or pharmacy service) were included. Methodologic quality was assessed and methodologic details and outcomes were extracted in duplicate. RESULTS: Six RCTs were identified. A total of 887 patients with an established diagnosis of depression who were initiating or maintaining pharmacologic treatment with antidepressant drugs and who received pharmacist care (459 patients) or usual care (428 patients) were included in the review. The most commonly reported interventions were patient education and monitoring, monitoring and management of toxicity and adverse effects, adherence promotion, provision of written or visual information, and recommendation or implementation of changes or adjustments in medication. Overall, no statistical heterogeneity or publication bias was detected. The pooled odds ratio, using a random effects model, was 1.64 (95% CI 1.24 to 2.17). Subgroup analysis showed no statistically significant differences in results by type of pharmacist involved, adherence measure, diagnostic tool, or analysis strategy. CONCLUSIONS: These results suggest that pharmacist intervention is effective in the improvement of patient adherence to antidepressants. However, data are still limited and we would recommend more research in this area, specifically outside of the US.Sage Publications2011info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/52204Articles publicats en revistes (Farmàcia, Tecnologia Farmacèutica i Fisicoquímica)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: http://dx.doi.org/10.1345/aph.1P429Annals of Pharmacotherapy, 2011, vol. 45, num. 1, p. 39-48http://dx.doi.org/10.1345/aph.1P429(c) Rubio Valera, Maria et al., 2011info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/522042026-05-27T06:46:51Z
dc.title.none.fl_str_mv Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
title Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
spellingShingle Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
Rubio Valera, Maria
Depressió psíquica
Serveis farmacèutics
Cooperació dels malalts
Antidepressius
Atenció primària
Metaanàlisi
Mental depression
Pharmaceutical services
Patient compliance
Antidepressants
Primary health care
Meta-analysis
title_short Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
title_full Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
title_fullStr Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
title_full_unstemmed Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
title_sort Effectiveness of pharmacist care in the improvement of adherence to antidepressants: a systematic review and meta-analysis
dc.creator.none.fl_str_mv Rubio Valera, Maria
Serrano Blanco, Antoni
Magdalena Belío, Jesús
Fernández Sánchez, Ana
García Campayo, Javier
March Pujol, Marian
López del Hoyo, Yolanda
author Rubio Valera, Maria
author_facet Rubio Valera, Maria
Serrano Blanco, Antoni
Magdalena Belío, Jesús
Fernández Sánchez, Ana
García Campayo, Javier
March Pujol, Marian
López del Hoyo, Yolanda
author_role author
author2 Serrano Blanco, Antoni
Magdalena Belío, Jesús
Fernández Sánchez, Ana
García Campayo, Javier
March Pujol, Marian
López del Hoyo, Yolanda
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Depressió psíquica
Serveis farmacèutics
Cooperació dels malalts
Antidepressius
Atenció primària
Metaanàlisi
Mental depression
Pharmaceutical services
Patient compliance
Antidepressants
Primary health care
Meta-analysis
topic Depressió psíquica
Serveis farmacèutics
Cooperació dels malalts
Antidepressius
Atenció primària
Metaanàlisi
Mental depression
Pharmaceutical services
Patient compliance
Antidepressants
Primary health care
Meta-analysis
description BACKGROUND: Pharmacists can play a decisive role in the management of ambulatory patients with depression who have poor adherence to antidepressant drugs. OBJECTIVE: To systematically evaluate the effectiveness of pharmacist care in improving adherence of depressed outpatients to antidepressants. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. RCTs were identified through electronic databases (MEDLINE, Cochrane Central Register of Controlled Trials, Institute for Scientific Information Web of Knowledge, and Spanish National Research Council) from inception to April 2010, reference lists were checked, and experts were consulted. RCTs that evaluated the impact of pharmacist interventions on improving adherence to antidepressants in depressed patients in an outpatient setting (community pharmacy or pharmacy service) were included. Methodologic quality was assessed and methodologic details and outcomes were extracted in duplicate. RESULTS: Six RCTs were identified. A total of 887 patients with an established diagnosis of depression who were initiating or maintaining pharmacologic treatment with antidepressant drugs and who received pharmacist care (459 patients) or usual care (428 patients) were included in the review. The most commonly reported interventions were patient education and monitoring, monitoring and management of toxicity and adverse effects, adherence promotion, provision of written or visual information, and recommendation or implementation of changes or adjustments in medication. Overall, no statistical heterogeneity or publication bias was detected. The pooled odds ratio, using a random effects model, was 1.64 (95% CI 1.24 to 2.17). Subgroup analysis showed no statistically significant differences in results by type of pharmacist involved, adherence measure, diagnostic tool, or analysis strategy. CONCLUSIONS: These results suggest that pharmacist intervention is effective in the improvement of patient adherence to antidepressants. However, data are still limited and we would recommend more research in this area, specifically outside of the US.
publishDate 2011
dc.date.none.fl_str_mv 2011
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/52204
url https://hdl.handle.net/2445/52204
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: http://dx.doi.org/10.1345/aph.1P429
Annals of Pharmacotherapy, 2011, vol. 45, num. 1, p. 39-48
http://dx.doi.org/10.1345/aph.1P429
dc.rights.none.fl_str_mv (c) Rubio Valera, Maria et al., 2011
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Rubio Valera, Maria et al., 2011
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sage Publications
publisher.none.fl_str_mv Sage Publications
dc.source.none.fl_str_mv Articles publicats en revistes (Farmàcia, Tecnologia Farmacèutica i Fisicoquímica)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300724

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