Impact of Pharmacist Activities in Patients With Depression: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

ABSTRACT

BACKGROUND: Depression is a substantial health burden. Pharmacist activities may help improve health outcomes of patients with depression when comparing to current practice with no pharmacist-involved intervention. OBJECTIVE: To systematically review and analyze randomized controlled trials assessing the impact of pharmacist services on patients with depression compared to usual care using a meta-analysis approach. METHODS: Four international and 3 domestic electronic databases were systematically searched. Data from database inception to December 2019 were included. Studies were selected using predefined inclusion criteria, and quality was assessed using the risk-of-bias criteria. Pooled estimation was analyzed to report the relative risk (RR) and standard mean difference (SMD). The meta-analysis used the random-effect model when heterogeneity was observed between studies. RESULTS: A total of 12 eligible studies with 2133 patients with depression were included in the analysis. The relevant pharmacist interventions included medication therapy management, adherence counseling, and educational advice about depression and antidepressants. Pooled data in the meta-analysis showed a significantly increased number of patients with good adherence (RR = 1.39; 95% CI = 1.11 to 1.75) and improved medication adherence score (SMD = 0.32; 95% CI = 0.07 to 0.56) associated with pharmacist activities compared to usual care. No significant differences were detected in clinical rating scales (SMD = -0.03; 95% CI = -0.16 to 0.10) and quality of life (SMD = 0.10; 95% CI = -0.04 to 0.25). CONCLUSION AND RELEVANCE This review suggests that the role of pharmacists in patients with depression has a positive impact on medication adherence.