Background Adherence to antidepressant treatment is an essential step for the management of major depressive disorder patients. Patients actively make decisions about their adherence to medicines.
Purpose To evaluate the effectiveness of a pharmacist intervention based on shared decision making (SDM) to improve adherence and patient outcomes compared to usual care in patients diagnosed with major depression disorder (MDD).
Material and methods A prospective randomised controlled study, with 6-month follow-up, with randomisation of participants to two alternative groups as follows: 1) interventions based on SDM, to enhance patient adherence (IG) 2) usual pharmaceutical care group (CG). The study was conducted in an outpatients department in a psychiatric hospital. Patient adherence, treatment beliefs, patient satisfaction with depression treatment, severity of depression, health-related quality of life and quality of patients’ involvement in SDM were collected at baseline, three and six months.
Results 239 patients were met the inclusion criteria during recruitment for this study, randomised to the IG (n = 119) or CG (n = 120); 19 patients completely dropped out of the study (10 patients from CG and 9 from IG). The average age was 39 years in the experimental group and 40 years in the control group. At the end of six months’ follow-up patients in the IG showed significant different in adherence to medicines, treatment satisfaction, general overuse beliefs, specific concerns beliefs and the total general beliefs about medicines compared with CG. On the other hand severity of depression and health-related quality of life showed statically insignificant differences at the end of six months comparing with CG.
Conclusion Pharmacist intervention based on SDM significantly improved adherence, treatment satisfaction and patients’ belief in antidepressants compared to usual care. We believe it will be a useful practice for regular psychiatric pharmacy care after a cost-effectiveness evaluation of this intervention.
References and/or Acknowledgements No conflict of interest.
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