An Exploratory Study of Pharmacist Self-Reported Antidepressant Medication Counseling Behaviors

Abstract

Depression is a relatively common and serious mental health disorder, which is expected to become the second leading disease burden worldwide in the next decade. Despite the already high and increasing prevalence of depression, not all individuals who suffer with depression receive proper treatment in the primary care setting. Because problems exist when treating depression solely in primary care and these problems can be exacerbated by patient factors, pharmacists are in an excellent position to help address these problems through the provision of antidepressant counseling. The primary purpose of this study was to identify and examine factors that are important to pharmacists’ engagement in antidepressant counseling. This study was the first known study to examine the applicability of aspects of the Theory of Planned Behavior and the Common Sense Model of Illness Representations together in an integrated model to identify and explain factors that affect pharmacists’ engagement in antidepressant counseling. Two types of antidepressant counseling behaviors were examined, reassurance and monitoring. Reassurance counseling behaviors included the provision of pharmacist evaluation of patient illness and medication knowledge, and ensuring adherence. Antidepressant monitoring behaviors included the monitoring of drug efficacy and side effects. A mixed methods approach was used to collect data from respondents. A questionnaire was mailed to 600 randomly selected Alabama community pharmacies. Responding community pharmacists completed a questionnaire in either paper or electronic format. Of the 600 questionnaires sent, a total of 119 responses were received; yielding an overall response rate of 20.6%. Four of the independent variables, consequences, control/cure of illness, episodic timeline, and self-efficacy, were found to be important predictors of pharmacists’ engagement in antidepressant reassurance counseling. No independent variables were found to be important predictors of pharmacists’ engagement in antidepressant monitoring. Study results show that personal factors are important predictors of pharmacists’ engagement in antidepressant counseling. This study suggests potential strategies for facilitating pharmacists’ engagement in antidepressant counseling. Further research is needed to identify other factors that are important to pharmacists’ engagement in antidepressant counseling.