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Publication Date
5-2021
Keywords
oregon; portland
Disciplines
Pharmacy and Pharmaceutical Sciences
Abstract
Background
• Depression affects almost 10 of Americans over 18 years old 1 • Per the Centers for Disease and Control Prevention, the 2020 COVID 19 pandemic has led to an increase in adults struggling with mental health 1 • There is currently a shortage of mental health prescribers, with over half of all counties within the United States not having a single psychiatrist 2 • Southern Oregon also has a shortage of mental health prescribers, resulting in longer wait times for care • Evidence demonstrates that depression managed by pharmacists in the primary care setting led to increased follow up frequency, increased medication adherence, improved PHQ 9 scores, and patient satisfaction 3
Purpose
The purpose of this study is to quantify, characterize, assess, and identify the management trends of clinical pharmacy specialists ( that are managing depression of patients at Providence Medical Group (PMG)
Methods
• A retrospective chart review was performed on patients who were managed by a clinical pharmacist for depression from January 2019 through December 2020 This information was gathered via the intervention tracking tool within the electronic medical record ( The endpoints below were gathered for evaluation of management trends by the pharmacists • A presentation was provided to the PMG clinics in Southern Oregon, reviewing the depression collaborative practice agreement ( Patients referred after this presentation were followed up to four months and included in data analysis • In order to meet a power of 80 the calculated sample size is 32
Discussion
• Non pharmacologic measures were assessed at every patient visit, including addressing presence of support system, meeting with BHI, and exercise • Addressing adherence led to therapy changes based on patient specific needs such as switching antidepressant therapy to a longer acting agent due to lack of adherence • There were only three instances where regimens were augmented with an additional agent This potentially indicates pharmacists were attempting to identify the best primary medication before augmenting with an additional agent • At first visit, dose increase occurred for over 25 of the patients, demonstrating potential benefit of dose increases prior to referrals • The mean decrease in PHQ 9 scores shows a clinically significant improvement in depression severity for this subset of patients
Conclusions
• Based on the total number of depression referrals received, the depression CPA is currently underutilized • When a CPS is managing depression, there is consistent follow up to assess medication tolerance and response and more frequent follow up is available if needed • There was only one incidence where a medication was increased to a dose that only had anecdotal evidence, demonstrating a strong adherence to evidence based practice by the clinical pharmacists • These evidence based and meaningful interventions resulted in clinically significant improvements in depression severity
Specialty/Research Institute
Graduate Medical Education
Specialty/Research Institute
Pharmacy
Conference / Event Name
Academic Achievement Day, 2021
Location
Providence Medical Group
