Impact of pharmacist interventions on patients’ adherence to antidepressants and patient-reported outcomes: a systematic review

BACKGROUND Pharmacist intervention in improving patient adherence to antidepressants is coupled with better outcomes. AIMS The aim of this investigation was to systematically examine the published literature to explore different types of pharmacist interventions used for enhancing patient adherence to antidepressant medications. Three specific questions guided the review: what is the impact of pharmacist interventions on adherence to antidepressant medication? What is the impact of pharmacist interventions on patient-reported outcomes and patient satisfactions? What are the types of interventions used by pharmacists to enhance patients' adherence to antidepressants? SEARCH STRATEGIES A systematic review of the literature was conducted during August-November 2010 using PubMed, BIOSIS Previews(®) Web of Science, ScienceDirect, the Cochrane Library, PsycINFO(®), IngentaConnect™, Cambridge Journals Online, and Medscape databases. Key text words and medical subject headings included pharmacist intervention, medication intervention, depression, medication adherence, health-related quality of life, patient-reported outcomes, and antidepressants. RESULTS A total of 119 peer-reviewed papers were retrieved; 94 were excluded on the basis of abstract review and 13 after full-text analysis, resulting in twelve studies suitable for inclusion and intensive review. The most common intervention strategy that pharmacists utilized was a combination of patient education and drug monitoring. A cumulative patient adherence improvement in this review ranged from 15% to 27% attributed to utilization of different interventions and different combinations of interventions together with patient satisfaction with the treatment when depression improved. CONCLUSION This review suggests that pharmacist intervention is effective in the improvement of patient adherence to antidepressants. This may be a basis for more studies examining the effectiveness of innovative interventions by pharmacists to enhance patient adherence to antidepressant medications.