Pharmacy-based management for depression in adults

Sampson, Stephanie; Todd, Adam; Walton, Nick; Steele, Rachel; Webster, Lisa; Churchill, Rachel; McMillan, Dean; Gilbody, Simon; Ekers, David

doi:10.1002/14651858.cd013299

Cited by 3 publications

(4 citation statements)

References 47 publications

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“…CHEMIST adds to the existing limited evidence base on the use of CPs for the management of people's mental health-care needs. 42,43…”

Section: Rationale For Chemistmentioning

confidence: 99%

“…l To develop and refine study procedures (CP set-up and recruitment strategies; participant screening, recruitment and assessment; suitability of outcome measures; and data collection procedures) for testing in the external pilot RCT. 42 External pilot randomised controlled trial l To quantify the flow of participants (eligibility, recruitment and follow-up rates). l To evaluate proposed recruitment, assessment and outcome measure collection.…”

Section: Research Objectivesmentioning

confidence: 99%

“…l To conduct a process evaluation, using semistructured interviews with participants, pharmacy staff and GPs across a range of socioeconomic settings, to explore the acceptability of the ESI within the CP setting, elements of the ESI that were considered useful (or not), and the appropriateness of study procedures. 42…”

Section: Research Objectivesmentioning

confidence: 99%

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A psychological intervention by community pharmacies to prevent depression in adults with subthreshold depression and long-term conditions: the CHEMIST pilot RCT

et al. 2022

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Background Depression is common in people with long-term health conditions, and this combination can lead to worsened health outcomes and increased health-care costs. Subthreshold depression, a risk factor for major depression, is prevalent in this population, but many people remain untreated due to the demand on services. The community pharmacy may be an alternative setting to offer mental health support; however, insufficient evidence exists to support implementation. Objectives To conduct a feasibility study and pilot randomised controlled trial of a community pharmacy-delivered psychological intervention aimed at preventing depression in adults with long-term health conditions. Design A feasibility study with nested qualitative evaluation and an external pilot, two-arm, 1 : 1 individually randomised controlled trial with nested process and economic evaluations. Setting Community pharmacies in the north of England. Participants Adults aged ≥ 18 years with subthreshold depression and at least one long-term health condition. Intervention A bespoke enhanced support intervention (behavioural activation within a collaborative care framework) involving up to six sessions delivered by trained community pharmacy staff (intervention facilitators) compared with usual care. Main outcome measures Recruitment and retention rates, completeness of outcome measures and intervention engagement. The intended primary outcome was depression severity at 4 months, assessed by the Patient Health Questionnaire-9. Results In the feasibility study, 24 participants were recruited. Outcome measure completeness was 95–100%. Retention at 4 months was 83%. Seventeen participants (71%) commenced intervention sessions and all completed two or more sessions. Depression symptoms reduced slightly at 4 months. The process evaluation suggested that the intervention was acceptable to participants and intervention facilitators. In the pilot randomised controlled trial, 44 participants (target of 100 participants) were randomised (intervention, n = 24; usual care, n = 20). Outcome measure completeness was 100%. Retention at 4 months was 93%. Eighteen participants (75%) commenced intervention sessions and 16 completed two or more sessions. Depression symptoms reduced slightly at 4 months, with a slightly larger reduction in the usual-care arm, although the small sample size limits any conclusions. The process evaluation reported good acceptability of the intervention and identified barriers associated with study implementation and its impact on core pharmacy functions. The economic analysis revealed some indication of reduced resource use/costs associated with the intervention, but this is limited by the small sample size. Intervention costs were low. Limitations The main limitation is the small sample size due to difficulties with recruitment and barriers to implementing the study within existing pharmacy practices. Conclusions The community pharmacy represents a new setting to deliver a depression prevention intervention. Recruitment was a challenge and pharmacy staff encountered barriers to effective implementation of the study within busy pharmacy practice. Despite these challenges, good retention rates and intervention engagement were demonstrated, and process evaluation suggested that the intervention was acceptable in this setting. To the best of our knowledge, this is the first study to demonstrate that community pharmacy staff can be trained to deliver a depression prevention intervention. Future work Further work is needed to address barriers to recruitment, intervention delivery and implementation of psychological interventions in the community pharmacy setting. Trial registration This trial is registered as ISRCTN11290592. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 5. See the NIHR Journals Library website for further project information.

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“…CHEMIST adds to the existing limited evidence base on the use of CPs for the management of people's mental health-care needs. 42,43…”

Section: Rationale For Chemistmentioning

confidence: 99%

Section: Research Objectivesmentioning

confidence: 99%

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A psychological intervention by community pharmacies to prevent depression in adults with subthreshold depression and long-term conditions: the CHEMIST pilot RCT

et al. 2022

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“… 30 Other reviews have explored the literature pertaining to pharmacist-delivered interventions, for mental illnesses, generally, 31 32 and specifically for depression. 33 34 There have also been literature reviews pertaining to pharmacists’ roles in improving adherence to antidepressant medicines. 35–37 However, there is no comprehensive literature review specifically exploring pharmacists’ roles in providing services or care for people living with SPMI.…”

Section: Introductionmentioning

confidence: 99%

Pharmacists’ roles in supporting people living with severe and persistent mental illness: a systematic review protocol

et al. 2020

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IntroductionSevere and persistent mental illness (SPMI) can significantly impact a person’s social, personal and professional life. Previous studies have demonstrated pharmacists’ roles in mental healthcare; however, limited studies to date have focused on pharmacists’ roles in providing healthcare services, specifically, to people living with SPMI. The aim of this systematic review is to explore the pharmacists’ roles in providing support to people living with SPMI.Methods and analysisA systematic search will be conducted in Medline, Embase (Ovid), PsycINFO, CINAHL, Web of Science, Scopus, Cochrane Library, International Pharmaceutical Abstracts and ProQuest Dissertations and Theses to identify potentially relevant primary research for inclusion. This will be guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist for systematic reviews. All primary research publications regardless of study design exploring or reporting on pharmacists’ involvement in supporting people living with SPMI will be considered for inclusion. A tabular summary will be completed using data extracted from each included publication. Data synthesis and quality assessment methods will be chosen based on included study designs.Ethics and disseminationThe results will be published in a peer-reviewed journal and used to inform the development of a pharmacist-specific training package to support people living with SPMI.PROSPERO registration numberCRD42020170711.

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