Skip to main content

Advertisement

Log in

Contributions of community pharmacists to patients on antidepressants—a qualitative study among key informants

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Patients with an antidepressant drug treatment (ADT) report unmet needs and a significant proportion stop their ADT prematurely. Community pharmacists can play a key role in supporting these patients. Objective To explore the perspectives of various leaders in health care about the current and potential contributions of community pharmacists to patients on ADT. Setting The province of Quebec (Canada). Method We conducted a qualitative descriptive exploratory study using interviews among leaders who were involved in health care services, pharmaceutical services, physician and pharmacist education, as well as patient and healthcare professional associations. Verbatim transcripts of interviews were analyzed using computer-assisted thematic analysis. Main outcome measure Perspectives about the contributions of community pharmacists to patients on ADT. Results Interviews revealed that pharmacists are perceived to be accessible drug experts whose particular strengths are their thorough knowledge of drugs, their commitment to ensure ADT safety and tolerability, as well as their commitment to inform and support patients. Leaders trained in pharmacy or representatives of pharmacy organizations had concrete expectations for pharmacists’ increased involvement in monitoring ADT adherence and efficacy. They extensively discussed the regulatory and organizational changes required to enhance this role. Leaders also stated that, in addition to patients, health care teams could benefit from pharmacists’ expertise and support. Conclusion Participating key informants perceived the need for enhanced pharmacist monitoring of ADT adherence and efficacy. They also expressed their openness to an increased collaboration between health care teams and pharmacists.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Patten SB, Kennedy SH, Lam RW, O'Donnovan C, Filteau MJ, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults I. Classification, burden and principles of management. J Affect Disord. 2009;117(Suppl 1):S5–14.

  2. Lingam R, Scott J. Treatment non-adherence in affective disorders. Acta Psychiatr Scand. 2002;105(3):164–72.

    Article  PubMed  Google Scholar 

  3. Olfson M, Marcus SC, Tedeschi M, Wan GJ. Continuity of antidepressant treatment for adults with depression in the United States. Am J Psychiatry. 2006;163:101–8.

    Article  PubMed  Google Scholar 

  4. Hodgkin D, Volpe-Vartanian J, Alegria M. Discontinuation of antidepressant medication among Latinos in the USA. J Behav Health Serv Res. 2007;34:329–42.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Buus N, Johannessen H, Stage KB. Explanatory models of depression and treatment adherence to antidepressant medication: a qualitative interview study. Int J Nurs Stud. 2012;49:1220–9.

    Article  PubMed  Google Scholar 

  6. Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS. Stigma as a barrier to recovery: perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatr Serv. 2001;52:1615–20.

    Article  CAS  PubMed  Google Scholar 

  7. Thompson L, McCabe R. The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review. BMC Psychiatry. 2012;12:87.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bull SA, Hu XH, Hunkeler EM, Lee JY, Ming EE, Markson LE, et al. Discontinuation of use and switching of antidepressants: influence of patient-physician communication. JAMA. 2002;288:1403–9.

    Article  PubMed  Google Scholar 

  9. Mitchell AJ. Depressed patients and treatment adherence. Lancet. 2006;367:2041–3.

    Article  PubMed  Google Scholar 

  10. Garfield S, Francis S-A, Smith FJ. Building concordant relationships with patients starting antidepressant medication. Patient Educ Couns. 2004;55:241–6.

    Article  PubMed  Google Scholar 

  11. Tibaldi G, Salvador-Carulla L, Garcia-Gutierrez JC. From treatment adherence to advanced shared decision making: new professional strategies and attitudes in mental health care. Curr Clin Pharmacol. 2011;6:91–9.

    Article  PubMed  Google Scholar 

  12. Adams JR, Drake RE, Wolford GL. Shared decision-making preferences of people with severe mental illness. Psychiatr Serv. 2007;58(9):1219–21.

    Article  PubMed  Google Scholar 

  13. Maidment R, Livingston G, Katona C. ‘Just keep taking the tablets’: adherence to antidepressant treatment in older people in primary care. Int J Geriatr Psychiatry. 2002;17:752–7.

    Article  PubMed  Google Scholar 

  14. Swanson KA, Bastani R, Rubenstein LV, Meredith LS, Ford DE. Effect of mental health care and shared decision making on patient satisfaction in a community sample of patients with depression. Med Care Res Rev. 2007;64:416–30.

    Article  PubMed  Google Scholar 

  15. Phokeo V, Sproule B, Raman-Wilms L. Community pharmacists’ attitudes toward and professional interactions with users of psychiatric medication. Psychiatr Serv. 2004;55:1434–6.

    Article  PubMed  Google Scholar 

  16. Liekens S, Smits T, Laekeman G, Foulon V. Pharmaceutical care for people with depression: Belgian pharmacists’ attitudes and perceived barriers. Int J Clin Pharm. 2012;34:452–9.

  17. Scheerder G, De Coster I, Van Audenhove C. Pharmacists’ role in depression care: a survey of attitudes, current practices, and barriers. Psychiatr Serv. 2008;59:1155–60.

    Article  PubMed  Google Scholar 

  18. Chong WW, Aslani P, Chen TF. Pharmacist–patient communication on use of antidepressants: a simulated patient study in community pharmacy. RSAP. 2014;10:419–37.

    PubMed  Google Scholar 

  19. Guillaumie L, Moisan J, Grégoire J-P, Villeneuve D, Beaucage C, Bujold M, et al. Perspective of community pharmacists on their practice with patients who have an antidepressant drug treatment: findings from a focus group study. RSAP. 2015;11:e43–56.

    PubMed  Google Scholar 

  20. Gardner DM, Murphy AL, Woodman AK, Connelly S. Community pharmacy services for antidepressant users. Int J Pharm Pract. 2001;9:217–24.

    Article  Google Scholar 

  21. Cannon-Breland ML, Westrick SC, Kavookjian J, Berger BA, Shannon DM, Lorenz RA. Pharmacist self-reported antidepressant medication counseling. J Am Pharm Assoc. 2012;53:390–9.

    Article  Google Scholar 

  22. Chong WW, Aslani P, Chen TF. Adherence to antidepressant medications: an evaluation of community pharmacists’ counseling practices. Patient Prefer Adherence. 2013;7:813–25.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Marshall MN. The key informant technique. Fam Pract. 1996;13(1):92–7.

    Article  CAS  PubMed  Google Scholar 

  24. Miles MB, Huberman AM, Saldaña J. Qualitative data analysis: a methods sourcebook. Thousand Oaks: SAGE Publications, Inc; 2013.

    Google Scholar 

  25. Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. Thousand Oaks: SAGE publications, Inc; 2013.

    Google Scholar 

  26. Burgess RG. In the field: an introduction to field research. Abingdon: Routledge; 2002.

    Google Scholar 

  27. Saldaña J. The coding manual for qualitative researchers. Thousand Oaks: SAGE Publications, Inc; 2009.

    Google Scholar 

  28. Paillé P, Mucchielli A. L’analyse qualitative en sciences humaines et sociales. 2nd ed. Paris: Armand Colin; 2003.

    Google Scholar 

  29. Tarn DM, Paterniti DA, Wenger NS, Williams BR, Chewning BA. Older patient, physician and pharmacist perspectives about community pharmacists’ roles. Int J Pharm Pract. 2012;20(5):285–93.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Bradshaw SJ, Doucette WR. Community pharmacists as patient advocates: physician attitudes. J Am Pharm Assoc. 1997;38(5):598–602.

    Article  Google Scholar 

  31. Howard M, Trim K, Woodward C, Dolovich L, Sellors C, Kaczorowski J, et al. Collaboration between community pharmacists and family physicians: lessons learned from the Seniors Medication Assessment Research Trial. J Am Pharm Assoc. 2002;43(5):566–72.

    Article  Google Scholar 

  32. Edmunds J, Calnan MW. The reprofessionalisation of community pharmacy? An exploration of attitudes to extended roles for community pharmacists amongst pharmacists and General Practioners in the United Kingdom. Soc Sci Med. 2001;53(7):943–55.

    Article  CAS  PubMed  Google Scholar 

  33. Hughes CM, McCann S. Perceived interprofessional barriers between community pharmacists and general practitioners: a qualitative assessment. Br J Gen Pract. 2003;53(493):600–6.

    PubMed  PubMed Central  Google Scholar 

  34. Ordre des pharmaciens du Québec. Standards de pratique. Montréal: Direction des servies professionnels, Ordre des pharmaciens du Québec; 2010.

    Google Scholar 

  35. Pottie K, Farrell B, Haydt S, Dolovich L, Sellors C, Kennie N, et al. Integrating pharmacists into family practice teams: physicians’ perspectives on collaborative care. Can Fam Physician. 2008;54(12):1714–1717.e5.

    PubMed  PubMed Central  Google Scholar 

  36. Smith M, Cannon-Breland ML, Spiggle S. Consumer, physician, and payer perspectives on primary care medication management services with a shared resource pharmacists network. RSAP. 2014;10(3):539–53.

    PubMed  Google Scholar 

  37. Loi sur la pharmacie. Gouvernement du Québec. 2015. http://www2.publicationsduquebec.gouv.qc.ca/dynamicSearch/telecharge.php?type=2&file=/P_10/P10.HTM. Accessed 26 May 2016.

  38. Surveillance de la thérapie médicamenteuse. Lignes directrices. Ordre des pharmaciens du Québec. http://www.opq.org/cms/Media/807_38_fr-CA_0_ld_surveillance_therapie_med.pdf. Accessed 02 July 2014.

  39. Guide de pratique 1-Fournir des soins pharmaceutiques. Ordre des pharmaciens du Québec. http://guide.opq.org/1_Role_03.html. Accessed 02 July 2014.

  40. Grainger-Rousseau TJ, Miralles MA, Hepler CD, Segal R, Doty RE, Ben-Joseph R. Therapeutic outcomes monitoring: application of pharmaceutical care guidelines to community pharmacy. J Am Pharm Assoc (Wash). 1997;NS37(6):647–61.

    Article  CAS  Google Scholar 

  41. Francke A, Smit M, de Veer A, Mistiaen P. Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review. BMC Med Inform Decis Mak. 2008;8(1):38.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Roberts AS, Benrimoj SI, Chen TF, Williams KA, Aslani P. Practice change in community pharmacy: quantification of facilitators. Annals Pharmacother. 2008;42(6):861–8.

    Article  Google Scholar 

  43. Tsuyuki RT, Schindel TJ. Changing pharmacy practice: the leadership challenge. Can Pharm J. 2008;141(3):174–80.

    Article  Google Scholar 

Download references

Funding

Unrestricted Grant from the Prends soin de toi program (AstraZeneca, Lilly, Lundbeck and Merck). L. Guillaumie received a post-doctoral research scholarship from the Chair on adherence to treatments. The Chair on Adherence to Treatments is funded through unrestricted Grants from AstraZeneca Canada, Merck Canada, Pfizer Canada, Sanofi Canada and the Prends soin de toi program S. Lauzier is a research scholar from the Fonds de recherche du QuébecSanté in partnership with the Institut national d’excellence en santé et en services sociaux.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sophie Lauzier.

Ethics declarations

Conflicts of interest

D. V. is president of Panacée Conseil providing professional development services to pharmacists. Other authors have no conflicts to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guillaumie, L., Moisan, J., Grégoire, JP. et al. Contributions of community pharmacists to patients on antidepressants—a qualitative study among key informants. Int J Clin Pharm 39, 686–696 (2017). https://doi.org/10.1007/s11096-017-0502-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-017-0502-y

Keywords

Navigation